1.

SATUAN KERJA ADALAH NAMA APOTEK, FKTP, FKRTL atau DINKES PROVINSI dan KAB/KOTA
2. SISA STOK PER 31 DESEMBER 2020 ADALAH SISA STOK PER 31 DESEMBER 2020 DI SATUAN KERJA
3. PREDIKSI PENGADAAN TAHUN 2021 ADALAH PREDIKSI JUMLAH YANG DIRENCANAKAN UNTUK DIADAKAN TAHUN 2021
4. PEMAKAIAN RATA-RATA PER BULAN SELAMA 2020 ADALAH PEMAKAIAN RATA-RATA PER BULAN DI SATKER SELAMA TAHUN
5. PREDIKSI SISA STOK 31 DESEMBER 2021 ADALAH SISA STOK PER 31 DESEMBER 2020 DITAMBAH PREDIKSI PENGADAAN TAH
6. JUMLAH KEBUTUHAN TAHUN 2022 ADALAH PEMAKAIAN RATA-RATA PER BULAN SELAMA 2020 DIKALI 15 BULAN DALAM S
7. RENCANA KEBUTUHAN TAHUN 2022 ADALAH JUMLAH KEBUTUHAN YANG DIHITUNG BERDASARKAN METODE KONSUMSI D
8. RENCANA PENGADAAN TAHUN 2022 ADALAH RENCANA UNTUK PENGADAAN DI TAHUN 2022 DALAM SATUAN TERKECIL SE
9. RENCANA PENGADAAN TAHUN 2021 ADALAH OTOMATIS TERISI DARI SISTEM JIKA SATKER TELAH MENGIRIMKAN PELAPOR
10. REALISASI PENGADAAN TAHUN 2020 ADALAH REALISASI PENGADAAN OBAT JKN BAIK E-PURCHASING MAUPUN MANUAL

RENCANA KEBUTUHAN OBAT PADA FASILITAS KESEHATAN RUJUKAN TINGKAT LANJU

SATUAN KERJA : RSKIA Harapan Bunda Kota Bandung

NO NAMA OBAT SATUAN

1 153-Sm-EDTMP (ethylenediamine tetramethylene phosphonic acid) 44 Tab

mg Ca/Na EDTMP, 5-46 ?g samarium, dan 1850 ± 185 mbq samarium 153
per ml

2 Abacavir 300 mg Tablet/kaplet/kaps

3 Adefovir dipivoksil tab 10 mg tablet/kapsul/kapl
4 Adenosin inj 3 mg/mL ampul/vial
5 Afatinib tab sal selaput 20 mg tablet salut selap
6 Afatinib tab sal selaput 30 mg tablet salut selap
7 Afatinib tab sal selaput 40 mg tablet salut selapu
8 Air untuk injeksi Botol 100 ml
9 Air untuk injeksi Botol 250 ml
10 Air untuk injeksi ampul/vial/botol
11 Air untuk injeksi amp 20 ml ampul/vial/botol
12 Air untuk injeksi amp 25 ml ampul/vial/botol
13 Air untuk irigasi Flexy bag 500 ml
14 Air untuk irigasi inf Botol 500 ml
15 Air untuk irigasi lar inf 1000 ml botol @ 1.000 mL
16 Akarbose tab 100 mg tablet/kapsul/kap
17 Akarbose tab 50 mg tablet/kapsul/kap
18 Albendazol susp 200 mg/5 ml Botol
19 Albendazol tab 400 mg tablet/kapsul/kap
20 Albumin serum normal (human albumin) inj 20% 100 ml Botol
21 Albumin serum normal (human albumin) inj 20% 50 ml Botol
22 Albumin serum normal (human albumin) inj 25% 100 ml Botol
23 Albumin serum normal (human albumin) inj 25% 20 ml Botol
24 Albumin serum normal (human albumin) inj 25% 50 ml Botol
25 Albumin serum normal (human albumin) inj 5% 250 ml Botol
26 Albumin serum normal (human albumin) inj 5% 50 ml Botol
27 Alendronat Tab 70 mg tablet/kapsul/kapl
28 Alopurinol tab 100 mg Tab
29 Alopurinol tab 300 mg tablet/kapsul/kap
30 Alprazolam tab 0,25 mg tablet/kapsul/kap
31 Alprazolam tab 0,5 mg tablet/kapsul/kap
32 Alprazolam tab 1 mg tablet/kapsul/kap
33 Alteplase serb inj 50 mg/vial Vial
34 Amfoterisin B inj 50 mg/10 ml (i.v.) Ampul
35 Amfoterisin B salep mata 1% Tube
36 Amfoterisin B salep mata 3% Tube
37 Amikasin inj 250 mg/ml vial/ampul
38 Aminofilin inj 24 mg/ml ampul/vial 10 ml
39 Aminofilin tab 150 mg tablet/kapsul/kap
40 Aminofilin Tab 200 mg tablet/kapsul/kap
41 Amiodaron inj 150 mg/3 ml ampul/vial
42 Amiodaron tab 200 mg Tab
43 Amitriptilin tab sal 25 mg tablet/kapsul/kap
44 Amlodipin tab 10 mg tablet/kapsul/kap
45 Amlodipin tab 5 mg tablet/kapsul/kap
46 Amoksisilin drops 100 mg/ml Botol @20 ml
47 Amoksisilin drops 100 mg/ml Botol @10 ml
48 Amoksisilin drops 100 mg/ml Botol @15 ml
49 Amoksisilin sir forte 250 mg/5 ml botol 60 ml
50 Amoksisilin sir kering 125 mg/5 ml Botol
51 Amoksisilin tab 250 mg tablet/kapsul/kap
52 Amoksisilin tab 500 mg tablet/kapsul/kap
53 Ampisilin serb inj 1000 mg/vial ampul/vial
54 Ampisilin serb inj 250 mg/vial Vial
55 Analog insulin : intermediate acting inj 100 UI/ml (kemasan vial, cartridge vial/cartridge
disposible, penfill cartridge)
56 Analog insulin : mix insulin (inj 100 UI/ml) Vial/Cartridge
57 Analog insulin intermediate acting combine with short or long acting inj Penfill
100 IU/ml (25% insulin lispro), vial/cartridge diposible/penfill cartridge

58 Analog insulin intermediate acting combine with short or long acting inj Penfill
100 IU/ml (50% insulin lispro), vial/cartridge diposible/penfill cartridge

59 Analog Insulin long acting inj 100 IU/mL, vial/cartridge disposible/penfill Vial/Cartridge/Penf
cartridge
60 Analog insulin rapid acting inj 100 IU/mL Vial @10 ml
61 Analog insulin rapid acting inj 100 IU/mL cartridge disposibl
 62 Anastrozol tab 1 mg tablet/kapsul/kap
63 Anestetik lokal gigi kombinasi : lidokain hcl 2% + epinefrin 1 : 80.000 inj 2 ampul/vial
ml
64 Antasida, kombinasi : aluminium hidroksida 200 mg + magnesium tablet/kapsul/kap
hidroksida 200 mg
65 Antasida, kombinasi : aluminium hidroksida 200 mg + magnesium botol 60 ml
hidroksida 200 mg
66 Anti Parkinson kombinasi : benzerasid 25 mg + levodopa 100 mg Kaps
67 Antibakteri, kombinasi : basitrasin 500 UI/g+ Polimiksin B 10.000 UI/g Tube

68 Antifungi salep, kombinasi : asam benzoat 6%+ asam salisilat 3% pot 30 g

69 Antihemoroid, kombinasi: bismut subgalat 150 mg + heksaklorofen 2,5 Suppositoria
mg + lidokain lidokain 10 mg+ seng oksida 120 mg + sup ad 2 g

70 Aquadest cairan 500 ml Botol 500 ml

71 Aripiprazol oral solution 1 mg/ml botol
72 Aripiprazol tab 5 mg tablet/kapsul/kapl
73 Aripiprazol tab discmelt 10 mg tab discmelt/tab ce
74 Aripiprazol tab discmelt 15 mg tab discmelt/ tab c
75 Artesunat serb inj 60 mg/ml (i.v./i.m.) ampul/vial
76 Articulating paper kertas warna penanda oklusi Kertas warna pena
77 Asam asetat tetes telinga 2% Botol
78 Asam asetilsalisilat (asetosal) tab 100 mg tablet sal enterik/
79 Asam asetilsalisilat (asetosal) tab 80 mg tablet/kapsul/kapl
80 Asam askorbat (vitamin C) tab 250 mg Tab
81 Asam askorbat (vitamin C) tab 50 mg tablet/kapsul/kapl
82 Asam folat tab 0,4 mg tablet/kapsul/kapl
83 Asam folat tab 1 mg tablet/kapsul/kapl
84 Asam folat tab 5 mg Tab
85 Asam fusidat tts mata 1% Botol @5 ml
86 Asam Fusidat tts mata 1% catchcover, botol
87 Asam ibandronat inj 1 mg/ml ampul/vial
88 Asam mefenamat kaps 250 mg tablet/kapsul/kapl
89 Asam mefenamat kaps 500 mg tablet/kapsul/kap
90 Asam pipemidat kaps 400 mg tablet/kapsul/kapl
91 Asam retinoat krim 0,05% Tube/pot
92 Asam retinoat krim 0,1% Tube @ 20 gram
93 Asam retinoat krim 0,1% Tube @ 10 gram
94 Asam salisilat lar 0,1% Botol
95 Asam salisilat salep 10% Tube
96 Asam salisilat salep 2% Tube
97 Asam salisilat salep 5% Tube
98 Asam traneksamat inj 100 mg/ml ampul/vial
99 Asam traneksamat inj 50 mg/ml Ampul
100 Asam traneksamat tab 500 mg ampul/vial
101 Asam ursodeoksikolat kaps 250 mg tablet/kapsul/kapl
102 Asam zoledronat inf 4 mg/100 ml Botol
103 Asam Zoledronat Inf 5 mg/100 ml Botol
104 Asetazolamid tab 250 mg tablet/kapsul/kapl
105 Asiklovir salep mata 3% tube
106 Asiklovir serb inj 250 mg Ampul/vial
107 Asiklovir tab 200 mg tablet/kapsul/kapl
108 Asiklovir tab 400 mg tablet/kapsul/kapl
109 Asparaginase serb inj 10.000 UI/vial Vial
110 Atapulgit 600 mg tablet/kapsul/kapl
111 Atapulgit tab 630 mg tablet/kapsul/kapl
112 Atapulgit tablet 650 mg tablet/kapsul/kapl
113 Atapulgit tablet 750 mg Tab
114 Atenolol tab 100 mg tablet/kapsul/kapl
115 Atenolol tab 50 mg tablet/kapsul/kapl
116 Atorvastatin tab 10 mg tablet salut selapu
117 Atorvastatin tab 20 mg tablet salut selapu
118 Atrakurium inj 10 mg/ml (i.v) ampul/vial @ 5 ml
119 Atrakurium inj 10 mg/ml (i.v) ampul/vial @ 2,5
120 Atropin inj 0,25 mg/ml (i.m./i.v./s.k) Ampul
121 Atropin tab 0,5 mg Tab
122 Atropin tts mata 0,5% Botol
123 Atropin tts mata 1% Botol
124 Azatioprin tab 50 mg Tab
125 Azitromisin serb inj 500 mg ampul/vial
126 Azitromisin sir kering 200 mg/5 ml maks botol @60 m
127 Azitromisin tab 250 mg tablet/kapsul/kapl
128 Azitromisin tab 500 mg tablet salut selapu
129 Bahan tumpatan sementara lar, serb Botol
130 Barium sulfat serb 92 g/100 ml Botol
131 Barium sulfat serb 92 g/100 ml Disposible plastic
132 Barium sulfat susp 95% Botol plastik
133 Basiliksimab Inj 20 mg Vial
134 Bedak salisil serb 2% Dus/Sachet/Plasti
135 Bedakuilin fumarat tab 100 mg tablet/kapsul/kapl
136 Bendamustin serb inj 100 mg Vial
137 Bendamustin serb inj 25 mg Vial
138 Benzatin penisilin inj 1,2 juta UI/ml (i.m.) Vial
139 Benzatin penisilin inj 2,4 juta UI/ml (i.m.) Vial
140 Beraprost sodium tab 20 mcg tablet/kapsul/kapl
141 Betahistin tab 24 mg Tab
142 Betahistin tab 6 mg tablet/kapsul/kapl
143 Betaksolol tts mata 0,5% Botol @ 5 ml
144 Betaksolol tts mata 0,5% Catchcover, botol
145 Betametason krim 0,1% tube 5 gram
146 Betametason krim 0,5 mg/g Tube
147 Betametason salep 0,1% tube 5 gram
148 Betametason tts mata 1 mg/ml catchcover, botol
149 Betametason tts mata 1 mg/ml botol @5 ml
150 Bikalutamid tab sal 150 mg tablet salut/kaplet
151 Bikalutamid tab sal 50 mg tablet salut/kaplet
152 Bisakodil sup 10 mg Suppositoria
153 Bisakodil sup 5 mg Suppositoria
154 Bisakodil tab sal 5 mg tablet/kapsul/kapl
155 Bisoprolol tab 1,25 mg tablet/kapsul/kapl
156 Bisoprolol tab 10 mg tablet salut selap
157 Bisoprolol tab 2,5 mg tablet/kapsul/kapl
158 Bisoprolol tab 5 mg tablet salut selap
159 Bleomisin serb inj 15 mg/ml Vial
160 Brinzolamid tetes mata Botol
161 Bromokriptin tab 2,5 mg Tab
162 Budesonid cairan ih 0,25mg/ml Botol @ 4 ml
163 Budesonid cairan ih 0,25mg/ml, respoules 2 ml respoules
164 Budesonid cairan ih 0,5 mg/ml Botol @ 4 ml
165 Budesonid cairan ih 0,5 mg/ml, respoules 2 ml respoules
166 Budesonid serb ih 100 mcg/dosis Botol
167 Budesonid serb ih 200 mcg/dosis 200 dosis
168 Budesonid serb ih 200 mcg/dosis 100 dosis
169 Budesonid-formoterol (fixed combination) 160/4,5 mg (inhalasi), 120 Turbuhaler
dosis
170 Budesonid-formoterol (fixed combination) 160/4,5 mg (inhalasi), 120 rapihaler
dosis
171 Budesonid-formoterol (fixed combination) 160/4,5 mg (inhalasi), 60 dosis Turbuhaler

172 Budesonid-formoterol (fixed combination)* ih 80/4,5 mcg Turbuhaler

173 Budesonid-formoterol (fixed combination)* ih 80/4,5 mcg rapihaler
174 Bupivakain heavy inj 5 mg/ml (hcl) + glukosa 8% vial/ampul @4 ml
175 Bupivakain inj 5 mg/ml (p.v.) ampul/vial
176 Busulfan tab salut 2 mg Tab
177 Cardioplegia inj ampul/vial
178 Copper T set/buah
179 Dabigatran eteksilat kaps 110 mg tablet/kapsul/kap
180 Dabigatran eteksilat kaps 75 mg tablet/kapsul/kapl
181 Dakarbazin serb inj 100 mg/vial Vial
182 Dakarbazin serb inj 200 mg/vial Vial
183 Daklatasvir tab sal selaput 30 mg Tab
184 Daklatasvir tab sal selaput 60 mg Tab
185 Daktinomisin inj 0,5 mg/vial (i.v.) Vial
186 Dapson tab scored 100 mg Tab
187 Daunorubisin serb inj 20 mg/vial Vial
188 Deferasiroks tab disp 250 mg Tab
189 Deferasiroks tab disp 500 mg tablet dispersible/
190 Deferipron lar oral 100 mg/ml Botol
191 Deferipron tab sal 500 mg tab salut selaput/k
192 Deferoksamin mesilat serb inj 500 mg/vial Vial
193 Deksametason inj 5 mg/ml (i.v./i.m.) ampul/vial
194 Deksametason tab 0,5 mg tablet/kapsul/kapl
195 Deksmedetomidin Inj 100 mcg/ml ampul/vial
196 Delamanid tablet salut selaput 50 mg tablet salut selapu
197 Desfluran cairan ih Botol
198 Desmopresin nasal spray 10 mcg/puff Botol
199 Desmopresin tab 0,1 mg Tab
200 Desmopresin tab 0,2 mg Tab
201 Desogestrel tab 75 mcg Tab
202 Desoksimetason gel 0,05% Tube
203 Desoksimetason krim 0,25% tube 15 g
204 Desoksimetason krim 0,25% tube 10 g
205 Desoksimetason salep 0,25% tube 10 g
206 Dialisis peritoneal, larutan intraperitoneal - Extraneal ultrabag
207 Diazepam enema 10 mg/2,5 ml tube @ 2,5 mL
208 Diazepam enema 5 mg/2,5 ml tube @ 2,5 mL
209 Diazepam inj 5 mg/ml (i.v./i.m.) ampul/vial
210 Diazepam tab 2 mg tablet/kapsul/kap
211 Diazepam tab 5 mg tablet/kapsul/kapl
212 Dienogest tab 2 mg tablet/kapsul/kapl
213 Dietilkarbamazin tab 100 mg tablet/kapsul/kapl
214 Difenhidramin inj 10 mg/ml (i.v./i.m.) ampul/vial
215 Diflukortolon valerat salep berlemak 0,1% Tube
216 Digoksin inj 0,25 mg/ml ampul/vial
217 Digoksin tab 0,25 mg tablet/kapsul/kapl
218 Diltiazem hcl inj 5 mg/5 ml Ampul
219 Diltiazem inj 25 mg/5 ml ampul/vial
220 Diltiazem kaps SR 100 mg Kapsul lepas lamb
221 Diltiazem kaps SR 200 mg Kapsul lepas lamb
222 Diltiazem serb inj 10 mg/10 ml Ampul
223 Diltiazem serb inj 50 mg/vial Vial
224 Diltiazem tab 30 mg Tab
225 Dimenhidrinat tab 50 mg tablet/kapsul/kapl
226 Dinatrium edetat tts mata 0,35% (3,5 mg/ml) Botol
227 Dinatrium klodronat inj 60 mg/ml Botol
228 DMSA (dimercapto succinic acid) 1,1 mg meso-2, 3-dimercaptosuccinic Vial
acid/vial
229 Dobutamin inj 12,5 mg/ml ampul/vial
230 Dobutamin inj 25 mg/ml ampul/vial
231 Dobutamin inj 50 mg/ml ampul/vial
232 Doksazosin tab 1 mg tablet/kapsul/kapl
233 Doksazosin tab 2 mg tablet/kapsul/kapl
234 Doksisiklin kaps 100 mg tablet/kapsul/kapl
235 Doksisiklin kaps 50 mg tablet/kapsul/kapl
236 Doksorubisin serb inj 10 mg/vial (i.v.) Vial
237 Doksorubisin serb inj 50 mg/vial Vial
238 Dolutegravir tab 50 mg tablet/kapsul/kapl
239 Domperidon susp 5 mg/5 ml botol @60 ml
240 Domperidon tab 10 mg tablet/kapsul/kapl
241 Domperidon tts 5 mg/ml Botol
242 Donepezil tab 5 mg tablet salut selapu
243 Donepezil tab eff 10 mg tablet dispersible
244 Dopamin inj 40 mg/ml ampul/vial
245 Dosetaksel inj 20 mg Vial
246 Dosetaksel inj 40 mg/ml (vial 0,5 ml) Vial
247 Dosetaksel inj 40 mg/ml (vial 2 ml) Vial
248 Dosetaksel inj 80 mg Vial
249 DTPA (diethylene triamine pentaacetic acid) 2,06-2,5 mg pentetate Vial
calcium trisodium/ml
250 Dutasterid kaps 0,5 mg Kaps lunak
251 Efavirenz tab 200 mg Tablet
252 Efavirenz tab sal 600 mg tablet salut selapu
253 Efedrin inj 50 mg/ml ampul/vial
254 Eksemestan tab 25 mg tablet salut gula
255 Eltrombopag tab sal selaput 25 mg Tab
256 Eltrombopag tab sal selaput 50 mg Tab
257 Enoksaparin sodium inj 20 mg/0,2 ml Ampul
258 Enoksaparin sodium inj 40 mg/0,4 ml Ampul
259 Enoksaparin sodium inj 60 mg/0,6 ml Ampul
260 Entekavir tab sal selaput 0,5 mg tablet salut selapu
261 Entekavir tab sal selaput 1 mg tablet salut selapu
262 Epinefrin (adrenalin) inj 1 mg/ml Ampul
263 Epirubisin serb inj 2 mg/ml, vial 25 ml Vial 25 ml
264 Epirubisin serb inj 2 mg/ml, vial 5 ml Vial 5 ml
265 Epirubisin serb inj 50 mg Vial 25 mL
266 Ergokalsiferol (vitamin D2) kaps 50.000 UI Kaps
267 Ergokalsiferol (vitamin D2) susp 10.000 UI/ml Botol
268 Ergotamin tab 1 mg Tab
269 Eritromisin kaps 250 mg tablet/kapsul/kapl
270 Eritromisin sir 200 mg/5 ml Botol @ 60 ml
271 Eritromisin tab 500 mg tablet/kapsul/kapl
272 Eritropoetin-alfa inj 10.000 IU Vial
273 Eritropoetin-alfa inj 2.000 IU Vial
274 Eritropoetin-alfa inj 3.000 IU Vial
275 Eritropoetin-alfa inj 4.000 IU Vial
276 Eritropoetin-beta inj 2000 UI/0,3 ml Vial
277 Eritropoietin-Alfa Inj 4000 IU/0,5 ml Ampul
278 Erlotinib tab sal selaput 100 mg tablet salut selapu
279 Erlotinib tab sal selaput 150 mg tablet salut selapu
280 Esomeprazole inj 40 mg/vial ampul/vial
281 Estrogen terkonjugasi tab sal 0,625 mg tablet salut gula/k
282 Etambutol tab 400 mg tablet/kapsul/kapl
283 Etanol 70% cairan 70% Botol
284 Etil klorida semprot 100 ml Botol
285 Etonogestrel implan 68 mg Set
286 Etoposid inj 20 mg/ml Vial
287 Etoposid kaps 100 mg Kaps
288 Eugenol Botol
289 Everolimus tab 0,25 mg tablet/kapsul/kapl
290 Everolimus tab 0,5 mg tablet/kapsul/kapl
291 Faktor IX Kompleks Inj 50 IU/mL ampul/vial
292 Faktor IX kompleks serb inj 1.000 UI/vial + pelarut 10 ml Vial
293 Faktor IX kompleks serb inj 500 UI/vial + pelarut Vial
294 Faktor koagulasi II 14-35 UI, faktor koagulasi VII 7-20 UI, faktor koagulasi Vial
IX 25 UI, faktor koagulasi X 14-35 serb inj 250 IU/10 ml
295 Faktor koagulasi II 14-35 UI, faktor koagulasi VII 7-20 UI, faktor koagulasi Vial
IX 25 UI, faktor koagulasi X 14-35 serb inj 500 UI/20 ml UI

296 Faktor viia (rekombinan) serb inj 1 mg/vial + pelarut untuk injeksi ampul/vial

297 Faktor VIII (konsentrat) serb inj 230 -340 UI Vial

298 Faktor VIII (konsentrat) serb inj 480 - 600 UI Vial
299 Faktor VIII serb inj 1000 mg/vial Vial
300 Faktor VIII serb inj 250 IU Vial
301 Faktor VIII serb inj 500 IU Vial
302 Fenilefrin drops 10% Botol
303 Fenitoin Na inj 50 mg/ml (100 mg/ 2 mL) ampul @ 2 ml
304 Fenitoin Na kaps 100 mg Kaps
305 Fenitoin Na kaps 30 mg Kaps
306 Fenobarbital inj 100 mg/mL ampul/vial
307 Fenobarbital inj 50 mg/ml Ampul
308 Fenobarbital tab 100 mg Tab
309 Fenobarbital tab 30 mg tablet/kapsul/kapl
310 Fenofibrat kaps 100 mg tablet/kapsul/kapl
311 Fenofibrat kaps 300 mg tablet/kapsul/kapl
312 Fenoksimetil penisilin (penisilin V) tab 125 mg Tab
313 Fenoksimetil penisilin (penisilin V) tab 250 mg Tab
314 Fenoksimetil penisilin (penisilin V) tab 500 mg Tab
315 Fenoterol hbr aerosol 100 mcg/puff Botol
316 Fenoterol hbr cairan ih 0,1% Botol
317 Fentanil inj 0,05 mg/ml (ampul 10 ml) ampul/vial, @ 10
318 Fentanil inj 0,05 mg/ml (ampul 2 ml) ampul @ 2 mL
319 Fentanil patch 12,5 mcg/jam Patch
320 Fentanil patch 25 mcg/jam Patch
321 Ferrakrilum cairan 1% Botol
322 Filgrastim inj 300 mcg/ml ampul/vial
323 Finasterid tab 5 mg tablet/kapsul/kapl
324 Fitomenadion (vitamin K 1) inj 2 mg/ml (i.m.) ampul/vial
325 Fitomenadion (vitamin K 1) tab sal 10 mg Tab sal
326 Fitomenadion (vitamin K1) inj 10 mg/ml (i.m) tablet salut gula/k
327 Fludarabin inj 50 mg/vial Vial
328 Fludarabin tab sal 10 mg tablet salut/kaplet
329 Flufenazin inj 25 mg/ml (i.m.) Vial
330 Flukonazol inj 2 mg/ml Ampul
331 Flukonazol kaps 150 mg tablet/kapsul/kapl
332 Flukonazol kaps 50 mg Kaps
333 Fluoksetin kaps 10 mg tablet/kapsul/kapl
334 Fluoksetin kaps 20 mg tablet/kapsul/kapl
335 Fluor kapl 1 mg Kaplet
336 Fluor sediaan topikal Tube
337 Fluorescein Sodium/ Natrium Fluoresein inj 100 mg/mL Ampul/vial
338 Fluoro deoxy glucose (FDG) Vial
339 Fluorometolon tts mata 0,1% catchcover, botol
340 Fluorometolon tts mata 0,1% botol @5 ml
341 Fluorourasil Inj 25 mg/ml Vial
342 Fluorourasil inj 50 mg/mL (@ 10 mL) Ampul
343 Fluorourasil inj 50 mg/mL (@ 5 mL) Ampul
344 Flusinolon asetonid krim 0,025% tube @ 5g
345 Flusinolon asetonid salep 0,025% Tube 10 g
346 Flutikason furoat intranasal spray Botol
347 Flutikason propionat cairan ih 0,5 mg/dosis Botol
348 Flutikason Propionat MDI 50 mcg/semprot Botol
349 Fondaparinuks inj 2,5 mg/0,5 ml ampul/vial/prefill
350 Formokresol Botol
351 Fosfomisin Trometamol granula 3 g Sachet
352 Fraksi protein plasma lar inf 5% Botol
353 Framisetin Sulfat Tulle 1% Patch
354 Furosemid inj 10 mg/ml (i.v./i.m.) ampul/vial
355 Furosemid tab 40 mg tablet/kapsul/kapl
356 Gabapentin kaps 100 mg tablet/kapsul/kapl
357 Gabapentin kaps 300 mg tablet/kapsul/kapl
358 Gadobutrol Macrocyclic 5 ml Prefilled Syringe
359 Gadobutrol Macrocyclic 7,5 ml Prefilled Syringe
360 Gadoksetat disodium 0,25 mmol gadoksetat disodium/ml Vial
361 Galactose microparticle 200-400 mg micropart/ml Vial
362 Gansiklovir serb inj 500 mg/vial Vial
363 Garam Fe, setara dengan Fe elemental 15 mg/5 mL Botol
364 Garam Fe, setara dengan Fe elemental 60 mg Botol
365 Garam Fe, setara dengan Fe elemental 60 mg Sachet
366 Garam oralit kombinasi : natrium klorida 0,52 g + kalium klorida 0,30 g + sachet
trinatrium sitrat 0,58 g + glukosa anhidrat 2,7 g
367 Gefitinib tab 250 mg tablet/kapsul/kapl
368 Gemfibrozil kaps 300 mg tablet/kapsul/kapl
369 Gemfibrozil kaps 600 mg tablet/kapsul/kapl
370 Gemsitabin inj 1000 mg/vial Vial
371 Gemsitabin inj 200 mg/vial Vial
372 Gentamisin inj 10 mg/ml Ampul
373 Gentamisin inj 40 mg/ml ampul/vial
374 Gentamisin salep mata 0,3% Tube
375 Gentamisin tsts mata 1% Botol
376 Gentamisin tts mata 0,3% Botol
377 Glass ionomer ART (Atraumatic Restorative Treatment) cocoa butter 5 g Sachet

378 Glass ionomer ART (Atraumatic Restorative Treatment) lar Botol

379 Glass ionomer ART (Atraumatic Restorative Treatment) serb Vial
380 Glibenklamid tab 2,5 mg tablet/kapsul/kapl
381 Glibenklamid tab 5 mg tablet/kapsul/kapl
382 Gliklazid tab 80 mg Tab
383 Gliklazid tab MR 30 mg Tab
384 Gliklazid tab SR 60 mg tablet lepas lamba
385 Glikopironium serb ih 50 mcg kapsul
386 Glikuidon tab 30 mg tablet/kapsul/kapl
387 Glimepirid tab 1 mg tablet/kapsul/kapl
388 Glimepirid tab 2 mg tablet/kapsul/kapl
389 Glimepirid tab 3 mg tablet/kapsul/kapl
390 Glimepirid tab 4 mg tablet/kapsul/kapl
391 Glipizid tab 10 mg tablet/kapsul/kapl
392 Glipizid tab 5 mg tablet/kapsul/kapl
393 Gliseril trinitrat inj 10 mg/ml Ampul
394 Gliseril trinitrat inj 5 mg/ml Ampul
395 Gliseril trinitrat kaps lepas lambat 2,5 mg kapsul lepas lamba
396 Gliseril trinitrat kaps lepas lambat 5 mg kapsul lepas lamba
397 Gliseril trinitrat tab 0,5 mg tablet/kapsul/kapl
398 Gliserin lar 50% Botol
399 Gliserin tts 100 mg/ml Botol
400 Glukosa Larutan Infus 10% steril 100 ml Botol
401 Glukosa Larutan Infus 10% steril 250 ml Botol
402 Glukosa Larutan Infus 10% steril 500 ml Botol
403 Glukosa Larutan Infus 40% Ampul @25 ml
404 Glukosa Larutan Infus 5% steril 100 ml Botol
405 Glukosa Larutan Infus 5% steril 250 ml Botol
406 Glukosa Larutan Infus 5% steril 500 ml Botol
407 Goserelin asetat inj 10,8 mg/vial Vial
408 Goserelin asetat inj 3,6 mg/vial Vial
409 Griseofulvin (micronized) tab 125 mg tablet/kapsul/kapl
410 Griseofulvin (micronized) tab 500 mg Tab
411 Griseofulvin (micronized) tab scored 250 mg tablet/kapsul/kapl
412 Gutta percha dan paper points 15 - 40 mm Roll
413 Gutta percha dan paper points 45 - 80 mm Roll
414 Haloperidol inj 5 mg/ml (i.m.) Vial
415 Haloperidol inj 50 mg/ml (decanoat) Vial
416 Haloperidol tab 0,5 mg tablet/kapsul/kapl
417 Haloperidol tab 1,5 mg tablet/kapsul/kapl
418 Haloperidol tab 2 mg tablet/kapsul/kapl
419 Haloperidol tab 5 mg tablet/kapsul/kapl
420 Haloperidol tts 2 mg/ml botol
421 Halotan ih Botol
422 Hemodialisa lar Botol
423 Heparin, Na inj 5.000 UI/ml (i.v./s.k.) Vial
424 Hepatitis B imunoglobulin (human) inj 150 IU/1,5 ml Ampul
425 Hepatitis B imunoglobulin (human) Inj 220 IU/ml Syringe
426 Hidrogen peroksida cairan 3% Botol
427 Hidroklorotiazid tab 12,5 mg Tab
428 Hidroklorotiazid tab 25 mg tablet/kapsul/kapl
429 Hidrokortison krim 1% tube @ 5 g
430 Hidrokortison krim 2,5% tube @ 5 g
431 Hidrokortison serb inj 100 mg Vial
432 Hidrokortison Tab 20 mg Tab
433 Hidroksi klorokuin tab 200 mg Tab
434 Hidroksi urea tab 500 mg tablet/kapsul/kapl
435 Hiosina butilbromida inj 20 mg/ml ampul/vial
436 Hiosina butilbromida tab 10 mg tablet/kapsul/kapl
437 Homatropin tts mata 2% Botol
438 Human insulin : mix insulin inj 100 UI/ml Vial @10 mL
439 Human insulin : mix insulin inj 100 UI/ml vial/ cartridge disp
440 Human Insulin intermediate acting combine with short or long acting inj Cartridge, Penfill
100 IU/mL, cartridge disposible/penfill cartridge
441 Human insulin intermediate acting combine with short or long acting inj Vial
100 IU/mL, Vial 10 mL
442 Human Insulin intermediate acting inj 100 IU/ml, cartridge Cartridge, Penfill
disposible/penfill cartridge
443 Human Insulin intermediate acting inj 100 IU/Ml, Vial 10 mL Vial
444 Human Insulin intermediate acting inj 100 IU/mL, Vial 5 mL Vial
445 Human insulin short acting inj 100 IU/ml Vial @10 mL
446 Human insulin short acting inj 100 IU/ml Cartridge disposibl
447 Human tetanus imunoglobulin inj 250 UI (i.m.) Ampul
448 Human tetanus imunoglobulin inj 500 UI (i.m.) Ampul
449 Hydromorphone HCl tab oros 16 mg tablet lepas lamba
450 Hydromorphone HCl tab oros 8 mg tablet lepas lamba
451 Ibuprofen sir 100 mg/5 ml botol @ 60 ml
452 Ibuprofen sir 200 mg/5 ml botol @ 60 ml
453 Ibuprofen tab 200 mg tablet/kapsul/kap
454 Ibuprofen tab 400 mg tablet/kapsul/kapl
455 Idarubisin serb inj 20 mg Vial
456 Ifosfamid serb inj 1000 mg/vial Vial
457 Ifosfamid serb inj 2000 mg/vial Vial
458 Ifosfamid serb inj 500 mg/vial Vial
459 Iloprost ih 10 mcg/mL ampul/vial
460 Imatinib mesilat tab 100 mg tablet/kapsul/kapl
461 Imatinib Mesilat tab 400 mg tablet/kapsul/kapl
462 Imidapril tab 10 mg tablet/kapsul/kapl
463 Imidapril tab 5 mg tablet/kapsul/kapl
464 Imunoglobulin Intravena Inj 50 mg/ml, untuk terapi GBS (Guillain Bare Vial
Syndrom)
465 Indakaterol serb ih 150 mcg Kaps
466 Indakaterol serb ih 300 mcg Kaps
467 Iodiksanol vial 320 mg Iodium/100 ml ampul/vial/botol
468 Iodiksanol vial 320 mg Iodium/50 ml ampul/vial/botol
469 Iodium 131 Botol
470 Iodohippurate sodium I 131 37-74 mbq/ multiple-dose Vial
471 Ioheksol 180 - 300 mg Iodium/mL (300 mg/20 mL) ampul/vial/botol
472 Ioheksol 240-350 mg Iodium/ml (300 mg/75 ml) Vial
473 Ioheksol 240-350 mg Iodium/ml (350 mg/75 ml) ampul/vial/botol
474 Ioheksol Inj 140 - 350 mg Iodium/mL (350 mg/100 ml) ampul/vial/botol
475 Ioheksol Inj 140 - 350 mg Iodium/mL (350 mg/50 ml) Vial
476 Ioheksol Inj 180 - 300 mg Iodium/mL (300 mg/100 ml) ampul/vial/botol
477 Ioheksol Inj 180 - 300 mg Iodium/mL (300 mg/50 ml) ampul/vial/botol
478 Iopamidol 300 - 370 mg Iodium/mL (300 mg/100 mL) Ampul/vial/botol
479 Iopamidol 300 - 370 mg Iodium/mL (300 mg/50 mL) Ampul/vial/botol
480 Iopamidol 300 - 370 mg Iodium/mL (370 mg/100 mL) Vial
481 Iopamidol 300 - 370 mg Iodium/mL (370 mg/200 mL) Vial
482 Iopamidol 300 - 370 mg Iodium/mL (370 mg/50 mL) ampul/vial/botol
483 Iopromid 300 - 370 mg (300 mg/100 mL) Vial
484 Iopromid 300 - 370 mg (300 mg/50 mL) Vial
485 Iopromid 300 - 370 mg (370 mg/100 mL) Vial
486 Iopromid 300 - 370 mg (370 mg/50 mL) Vial
487 Ipratropium bromida aerosol 20 mcg/semprot Botol
488 Ipratropium bromida cairan ih 0,025% Botol
489 Irbesartan tab 150 mg tablet/kapsul/kapl
490 Irbesartan tab 300 mg tablet/kapsul/kapl
491 Irinotekan inf 20 mg/ml Ampul/vial @ 2 m
492 Irinotekan inf 20 mg/ml Ampul/vial @ 5 m
493 Irinotekan inj 20 mg/ml Ampul/vial @ 2 m
494 Irinotekan inj 20 mg/ml Ampul/vial @ 5 m
495 Isofluran inhalasi 100 ml Botol
496 Isofluran inhalasi 250 ml botol @ 250 mL
497 Isoniazid tab 100 mg Tab
498 Isoniazid tab 300 mg Tab
499 Isosorbid dinitrat inj 1 mg/ml (i.v) ampul/vial
500 Isosorbid dinitrat tab 10 mg tablet/kapsul/kapl
501 Isosorbid dinitrat tab 5 mg tablet/kapsul/kapl
502 Itrakonazol Kaps 100 mg tablet/kapsul/kapl
503 IUD Cu T 380 A Set
504 IUD Levonorgestrel Set
505 Ivabradin tab 5 mg tablet /kapsul/kap
506 k.y jelly Tube gel
507 Kalamin Tube
508 Kalium aspartat tab 300 mg tablet salut selapu
509 Kalium klorida / Potasium klorida injeksi 25 mg 7,46%, 25 mL Ampul/vial
510 Kalium klorida tab SR 600 mg tablet lepas lamba
511 Kalsitriol kaps lunak 0,25 mcg kapsul lunak
512 Kalsitriol kaps lunak 0,5 mcg kapsul lunak
513 Kalsium Folinat (Leukovorin, Ca) Inj 10 mg/ml ampul/vial
514 Kalsium folinat (leukovorin, Ca) tab 15 mg Tab
515 Kalsium glukonat inj 100 mg/ml ampul/vial
516 Kalsium hidroksida bubuk, pasta Tube
517 Kalsium hipoklorit Sachet
518 Kalsium karbonat tab 500 mg tablet/kapsul/kapl
519 Kalsium laktat (kalk) tab 500 mg tablet/kapsul/kapl
520 Kalsium polistirena sulfonat ktg 5 g Sachet
521 Kanamisin inj 1.000 mg/ vial Vial
522 Kandesartan tab 16 mg tablet/kapsul/kapl
523 Kandesartan tab 8 mg tablet/kapsul/kapl
524 Kapesitabin tab sal 500 mg tab salut/kaplet sa
525 Kaptopril tab 12,5 mg tablet/kaplet
526 Kaptopril tab 25 mg tablet/kaplet
527 Kaptopril tab 50 mg tablet/kaplet
528 Karbamazepin sir 100 mg/5 ml Botol
529 Karbamazepin tab 100 mg Tab
530 Karbamazepin Tab 200 mg Tablet
531 Karbimazol tab 5 mg tablet/kapsul/kapl
532 Karbogliserin tts telinga 10 % Botol
533 Karboksimetilselulosa tts mata Botol
534 Karboplatin Inj 10 mg (vial 45 ml) Vial
535 Karboplatin inj 10 mg/ml (vial 15 ml Vial
536 Karvedilol kaps 6,25 mg tablet/kapsul/kapl
537 Karvedilol tab 25 mg tablet/kapsul/kapl
538 Ketamin inj 100 mg/ml (i.v.) ampul/vial
539 Ketamin inj 50 mg/ml (i.v.) ampul/vial
540 Ketokonazol krim 2% Tube 10 g
541 Ketokonazol scalp sol 2% botol
542 Ketokonazol tab 200 mg tablet/kapsul/kapl
543 Ketoprofen Inj 25 mg/ml ampul/vial
544 Ketoprofen sup 100 mg Suppositoria
545 Ketorolak inj 30 mg/ml ampul/vial
546 Klaritromisin sir kering 125 mg/5 ml botol maks 60 mL
547 Klaritromisin sir kering 250 mg/5 ml Botol
548 Klaritromisin tab 500 mg tablet salut selapu
549 Klindamisin kaps 150 mg Kaps
550 Klindamisin kaps 300 mg tablet/kapsul/kap
551 Klobazam tab 10 mg tablet/kapsul/kap
552 Klobetasol propionat krim 0,05% tube
553 Klobetasol propionat salep 0,05% tube
554 Klofazimin, micronized kaps 50 mg Kapsul
555 Klofazimin, micronizedkaps 100 mg kapsul
556 Klomipramin tab 25 Tab
557 Klonazepam kaps 2 mg tablet salut selapu
558 Klonidin inj 150 mcg/ml Vial
559 Klonidin tab 0,15 mg tablet/kapsul/kap
560 Klopidogrel tab 75 mg tablet salut selapu
561 Klopidogrel tab sal selaput 300 mg tablet salut selapu
562 Kloral hidrat lar Botol
563 Klorambusil tab sal selaput 5 mg tab sal selaput
564 Kloramfenikol kaps 250 mg tablet/kapsul/kap
565 Kloramfenikol kaps 500 mg tablet/kapsul/kap
566 Kloramfenikol salep 2% tube 15g
567 Kloramfenikol salep mata 1% tube @ 5 gram
568 Kloramfenikol serb inj 1.000 mg/ml vial/ampul
569 Kloramfenikol susp 125 mg/5 ml botol 60 ml
570 Kloramfenikol tetes telinga 3% Botol
571 Kloramfenikol tts mata 0,5% botol
572 Kloramfenikol tts mata 1% Botol
573 Klorfeniramin tab 4 mg tablet/kapsul/kap
574 Klorfenol kamfer mentol (CHKM) Botol
575 Klorheksidin lar 0,2% Botol
576 Klorheksidin lar 15% Botol
577 Klorokuin tab 250 mg Tablet
578 Klorpromazin inj 25 mg/ml (i.m.) ampul/vial
579 Klorpromazin inj 5 mg/ml (i.m.) ampul/vial
580 Klorpromazin tab sal 100 mg tablet salut selapu
581 Klorpromazin tab sal 25 mg Tab sal
582 Klortalidon tab 50 mg Tab
583 Klotrimazol tab vagina 100 mg Tab
584 Klozapin tab 100 mg tablet
585 Klozapin tab 25 mg tablet
586 Kodein tab 10 mg tablet/kapsul/kapl
587 Kodein tab 15 mg tablet/kapsul/kapl
588 Kodein tab 20 mg tablet/kapsul/kapl
589 Kolestiramin serb, 4 g Ampul
590 Kolkisin tab 500 mcg Tab
591 Komb: Deksametason 0,1% Thymol 5% Paraklorphenol 30 Botol
592 Kombinasi (DHP) : dihidroartemisin 40 mg + Piperakuin 320 mg tab sal tablet salut selapu
selaput
593 Kombinasi : (Ampisilin 1000 mg + Sulbaktam 500 mg) serb inj 1500 mg ampul/vial

594 Kombinasi : (Sefoperazon 500 mg + Sulbaktam 500 mg) serb inj 1000 mg ampul/vial

595 Kombinasi : (Zidovudin 60 mg + Lamivudin 30 mg + Nevirapin 50 mg) Ped Tab dispersible

Triple FDC
596 Kombinasi : Ampisilin 500 mg + Sulbaktam 250 mg serb inj 750 mg ampul/vial
597 Kombinasi : artemether 20 mg + lumefantrin 120 mg tablet/kapsul/kapl
598 kombinasi : benserazid 25 mg + levodopa 100 mg tablet dispersible/
599 Kombinasi : Brinzolamid 1% + Timolol 0,5%, tts mata Botol
600 Kombinasi : Desogestrel 150 mcg Etinilestradiol 30 mcg Tab
601 Kombinasi : ergotamin 1 mg+ kafein 50 mg tablet/kapsul/kapl
602 Kombinasi : Ferro fumarat 60 mg + asam folat 0,4 mg tab salut tablet salut gula
603 Kombinasi : Indakaterol 110 mcg + Glycopyrronium 50 mcg serb ih + alat Botol
breezhaler
604 Kombinasi : Ipratropium bromida 0,02 mg + fenoterol HBr 0,05 mg Botol
aerosol
605 Kombinasi : levodopa 100 mg+Karbidopa 25 mg + entekapon 200 mg tablet/kapsul/kapl

606 Kombinasi : levonorgestrel 150 mcg + etinilestradiol 30 mcg tab salut gula
607 Kombinasi : medroksi progesteron asetat+ estradiol sipionat inj depot 25 Vial
mg + 5 mg
608 Kombinasi : Meglumin amidotrizoat + Sodium amidotrizoat inj 76% Vial

609 Kombinasi : Sefiksim 400 mg + Azitromisin 1000 mg Paket

610 Kombinasi : Tenofovir 300 mg + Emtrisitabin 200 mg Tab
611 Kombinasi : Tenofovir 300 mg + Lamivudin 300 mg + Efavirenz 600 mg Tab

612 Kombinasi : Travoprost 0,004% + Timolol 0,5%, tts mata Botol

613 Kombinasi : triamsinolon + dementilklortetrasiklin Pasta tube
614 Kombinasi : zidovudin 300 mg +lamivudin 150 mg Tab
615 Kombinasi KDT/FDC, setiap mL mengandung: latanoprost 0,05 mg + Botol 2,5 mL
timolol 5 mg tetes mata
616 Kombinasi KDT/FDC, setiap mL mengandung: latanoprost 0,05 mg + catchcover, botol
timolol 5 mg tetes mata
617 Kombinasi, setiap ml mengandung: natrium klorida 4,40 mg + kalium Catchcover, botol
klorida 0,80 mg (tetes mata)
618 Kombinasi, setiap ml mengandung: natrium klorida 4,40 mg + kalium Botol plastik @ 5
klorida 0,80 mg (tetes mata)
619 Kombinasi, setiap ml mengandung: natrium klorida 4,40 mg + kalium Botol Plastik @ 15
klorida 0,80 mg (tetes mata)
620 Kombinasi: Amoksisilin 1.000 mg + Asam klavulanat 200 mg, Inj 1.200 mg vial

621 Kombinasi: Elbasvir 50 mg dan Grazoprevir 100 mg tablet salut selaput tablet salut selapu

622 Kombinasi: Ipratropium bromida 0,5 mg + Salbutamol 2,5 mg, cairan ih Ampul/vial

623 Kombinasi: kaolin 550 mg + pektin 20 mg Tab

624 Kombinasi: lopinavir 200 mg + ritonavir (LVP) 50 mg, tab 250 mg Tab
625 Kombinasi: parafin + gliserin + fenolftalein Botol
626 Kombinasi: salmeterol 25 mcg + flutikason propionat 50 mcg ih 50 aerosol can/canist
mcg/puff
627 Kombinasi: salmeterol 50 mcg + flutikason propionat 100 mcg ih 100 Botol
mcg/puff
628 Kombinasi: salmeterol 50 mcg + flutikason propionat 500 mcg ih 500 Botol
mcg/puff
629 Kombinasi: salmeterol 50 mcg+ flutikason propionat 250 mcg ih 250 Botol
mcg/puff
630 Kombinasi: Tenofovir 300 mg + Lamivudin 300 mg + Dolutegravir 50 mg, Tablet/kapsul/kapl
tablet
631 Komibinasi: lidokain + medisinal creosote phenol + eugenol + benzil Botol
alkohol, cairan
632 Komposit resin Set
633 Kotrimoksazol (dewasa) kombinasi : sulfametoksazol 400 mg+ tab/kaptab
trimetoprim 80 mg
634 Kotrimoksazol (dewasa) kombinasi : sulfametoksazol 800 mg+ tab/kaptab
trimetoprim 160 mg
635 Kotrimoksazol kombinasi tiap 5 ml suspensi : sulfametoksazol 200 mg + botol 60 mL
trimetoprim 40 mg
636 Kuinin inj 25% (i.v.) Vial
637 Kuinin tab 200 mg tablet/kapsul/kapl
638 Laktulosa sir 3,335 g/5 ml botol @ 60 mL
639 Lamivudin (3TC) tab 150 mg tablet/kapsul/kapl
640 Lamivudin tab 100 mg tablet/kapsul/kapl
641 Lamotrigin Tab 100 mg Tab
642 Lamotrigin tab 50 mg Tablet
643 Lamotrigin tab dispersible 25 mg tablet dispersible/
644 Lansoprazol inj 30 mg/ml Vial
645 Lansoprazol kaps 30 mg tablet/kapsul/kapl
646 Lapatinib tab 250 mg tablet/kapsul/kapl
647 Larutan mengandung Asam Amino (Asam Amino 10%) Botol
648 Larutan mengandung Asam Amino (Asam Amino 100 g, Total N 15,7 g, Botol
Na+ 2 mEq, Asetat 120 mEq)
649 Larutan mengandung Asam Amino (Asam Amino 15 g, Glukosa 37,5 g, Softbag @500 mL
Tiamin HCl 0,75 mg, elektrolit)
650 Larutan mengandung Asam Amino (Asam Amino 27 g, Sorbitol 50 g, Cl-52 Botol
mEq)
651 Larutan mengandung Asam Amino (Asam Amino 30 g, Glukosa 7,3 % dan Botol
elektrolit) 1000 ml
652 Larutan mengandung Asam Amino (Asam Amino 30 g, Glukosa 7,3 % dan Botol
elektrolit) 500 ml
653 Larutan mengandung Asam Amino (Asam Amino 30 g, Glukosa 75 g, Softbag @1.000 m
Tiamin HCl 1,5 mg, elektrolit)
654 Larutan mengandung Asam Amino (Asam Amino 5% dengan BCAA 45%, Botol
L-Ornithine L Aspartate 8.03 gr/L, Sorbitol 50 gr/L, Xylitol 50 gr/L)

655 Larutan mengandung Asam Amino (Asam Amino 6%, mengandung Botol
Taurine 0,24 gr/l) : Aminosteril Infant 6%
656 Larutan mengandung Asam Amino (Asam Amino 7% (total protein 17,5 g) Botol
dengan kandungan asam amino esensial (EAA) dan non esensial (NEAA)
yang seimbang EAA : NEAA = 60 : 40))

657 Larutan mengandung Asam Amino (Asam Amino 72.05 g, Total N 11.53 g, Botol
AAE/AANE ratio 2.6, Na+ 2 mEq, Asetat 46 mEq)
658 Larutan mengandung Asam Amino (Asam Amino 79.9 g, Total N 12.2 g, Botol
Na+ 14 mEq, Cl 94 mEq)
659 Larutan mengandung Asam Amino (Asam amino 8%) : Aminosteril N- Botol
Hepa
660 Larutan mengandung Asam Amino (Asam Amino 9%, Komposisi: Asam Botol
Amino esensial: Asam Amino non esensial = 60 : 40)
661 Larutan mengandung Asam Amino (Asam Amino esensial 7%+Xylitol 10 Botol
g/L)
662 Larutan mengandung Asam Amino (BCAA 25 gr/L, L-Ornithine L Aspartate Botol
10 gr/L, Xylitol 50 gr/L, Malic Acid 7 gr/L, Piridoxin 0.12 gr/L)

663 Larutan mengandung Asam Amino (Glutamine 20 g) Botol

664 Larutan mengandung Asam Amino (Kombinasi : asam amino, glukosa, Botol
dan lipid) (Lipid Peri 1250)
665 Larutan mengandung Asam Amino (Kombinasi : glukosa, emulsi lemak, Botol
dan asam amino) (Lipid Special 1250)
666 Larutan mengandung Asam Amino (Kombinasi : glukosa, emulsi lemak, Botol
dan asam amino) (Lipid Special 625)
667 Larutan mengandung asam amino (kombinasi AA 50 g/L, sorbitol 50 g/L, Botol
Xylitol 50 g/L, vit C 0,4 g/L, Inositol 0,5 g/L, Niasinamid 0,06 g/L, vit B6
0,04 g/L, Riboplavin Na Fosfat 2,5 mg/L, elektrolit)

668 Larutan mengandung Asam Amino (Kombinasi Asam amino 50 g/L, Botol
vitamin dan elektrolit)
669 Larutan mengandung Asam Amino (Kombinasi Glukosa dan elektrolit 150 Botol
gr + Asam Amino 48 gr dgn akses sentral)
670 Larutan mengandung Asam Amino (Kombinasi Glukosa dan elektrolit 80 Botol
gr + Asam Amino 40 gr)
671 Larutan mengandung Asam Amino (N(2)-L-Alanyl-L-Glutamine/ N(2)-L- Botol/vial
Alanyl-L-Glutamine 20%)
672 Larutan mengandung Asam Amino + Elektrolit + Karbohidrat + Lipid Botol
(Kombinasi Asam Amino: 45gr, Glukosa: 130gr, Lipid: 68gr dan Elektrolit
(Kalori = 1400 kkal, Akses peripheral))

673 Larutan mengandung asam amino + elektrolit + Karbohidrat + Lipid Bag

(Glukosa 103 g, Asam amino 46 g, Elektrolit, Lipid 41 g dengan Fish Oil 6,1
g)

674 Larutan mengandung asam amino + elektrolit + Karbohidrat + Lipid Bag

(Glukosa 135 g, Asam amino 60 g, Elektrolit, Lipid 54 g dengan Fish Oil 8
g)

675 Larutan mengandung asam amino + elektrolit + Karbohidrat + Lipid Bag

(Glukosa 63 g, Asam amino 25 g, Elektrolit, Lipid 19 g dengan Fish Oil 2,8
g)

676 Larutan Mengandung Asam amino + Elektrolit + Karbohidrat + Lipid Botol

(Kombinasi Asam amino 56,9 g, Lipid 40 g, Glukosa 110 g dan Elektrolit)

677 Larutan mengandung Asam Amino + Elektrolit + Karbohidrat + Lipid Botol

(Kombinasi Asam Amino: 34gr, Glukosa: 97gr, Lipid: 51gr dan Elektrolit
(Kalori = 1000 kkal, Akses peripheral))

678 Larutan mengandung asam amino + Karbohidrat + Lipid (Glukosa 63 g, Bag

Asam amino 25 g, Lipid 19 g dengan Fish Oil 2,8 g)
679 Larutan mengandung elektrolit (CaCl2H2O 0,165 gr, KCl 0,15 gr, NaCl 4,3 Botol plastik @50
gr)
680 Larutan mengandung Elektrolit (Kalium Klorida) Botol
681 Larutan mengandung Elektrolit (KCl 0,15%, NaCL 0,9%) (KN1) Botol
682 Larutan mengandung Elektrolit (KCl 0,3%,NaCl 0,9%) (KN2) Botol
683 Larutan mengandung Elektrolit (Na 130 mEq, K 4 mEq, Cl 109 mEq, Ca 3 Botol plastik @ 50
mEq, Asetat 28 mEq) Ringer Asetat
684 Larutan mengandung Elektrolit (Na 130 mEq, K 4 mEq, Cl 109 mEq, Ca 3 Softbag @ 500 ml
mEq, Asetat 28 mEq) Ringer Asetat
685 Larutan mengandung Elektrolit (Sodium Lactate sol (50%) 113 gr/L, Botol
Potassium Chloride 0.3 gr/L, Calcium Chloride 0.2 gr/L, elektrolit)
686 Larutan mengandung Elektrolit (Tiap 1000 ml mengandung electrolit: Botol
Sodium 145 mmol/l, Potassium 4.0 mmol/l, Calcium 2.5 mmol/l,
Magnesium 1.0 mmol/l, Chloride 118 mmol/l, Acetate 24 mmol/l, Malate
5.0 mmol/l)

687 Larutan mengandung Karbohidrat + Elektrolit (D2,5%+KCL 0,15%+NaCl Botol

0,45%) (KDN1)
688 Larutan mengandung Karbohidrat + Elektrolit (D2,5%+KCL 0,3%+NaCl Botol
0,45%) (KDN2)
689 Larutan mengandung Karbohidrat (Fructose 120 g, glucose 66 g, Xylitol Botol
60 g/ L)
690 Larutan mengandung Karbohidrat (Fructose 15 mg, glucose monohydrate softbag
30 mg, xylitol 15 mg)
691 Larutan mengandung Karbohidrat (Fructose 200 g, glucose 110 g, Xylitol Botol
100 g/ L)
692 Larutan mengandung Karbohidrat (Fructose 60 g, glucose 33 g, Xylitol 30 Botol
g/ L)
693 Larutan mengandung Karbohidrat (Maltose 10%) Botol
694 Larutan mengandung Karbohidrat + Elektrolit (25.00g dextrose anhidrat, Botol plastik @50
3.00 g sodium chloride, 0.15 g potassium chloride, 0.10 g calcium
chloride dihydrate dan 1.55 g sodium lactate)

695 Larutan mengandung Karbohidrat + Elektrolit (25.00g maltose, 3.00 g Botol plastik @50
sodium chloride, 0.15 g potassium chloride, 0.10 g calcium chloride
dihydrate dan 1.55 g sodium lactate)

696 Larutan mengandung Karbohidrat + Elektrolit (Acetate, Na, K, Cl, Ca, Mg, Botol
Sorbitol 50 gr/L)
697 Larutan mengandung Karbohidrat + Elektrolit (Asam amino 28 gr/L, Botol
Glukosa 100 gr/L, elektrolit)
698 Larutan mengandung Karbohidrat + Elektrolit (Asam amino 28 gr/L, Botol
Glukosa 75 gr/L, elektrolit)
699 Larutan mengandung karbohidrat + elektrolit (Dextran 40 50 gr, Botol plastik @50
CaCl2H2O 0,1 gr, KCl 0,15 gr, NaCl 3 gr, Na lactate 1,55 gr)
700 Larutan mengandung Karbohidrat + Elektrolit (Dextrose 5%, NaCL 0,45%, Botol
KCl) (HSD)
701 Larutan mengandung Karbohidrat + Elektrolit (Fructose 120 g, glucose 66 Botol
g, Xylitol 60 g/ L + elektrolit)
702 Larutan mengandung Karbohidrat + Elektrolit (Glukosa 25 g, NaCl 2,0 g, Botol
KCl 1,3 g, Natrium Laktat 3,1 g, air untuk injeksi ad 1000 ml)
703 Larutan mengandung Karbohidrat + Elektrolit (Glukosa 55 g ; Natrium Botol
Chloride 9 g, air untuk injeksi ad 1000 ml) (D5-NS)
704 Larutan mengandung Karbohidrat + Elektrolit (Glukosa: 110.0 g; NaCl: botol/softbag
1.80 g) (D10-1/5NS)
705 Larutan mengandung Karbohidrat + Elektrolit (Glukosa: 25,0 g; NaCl: 4,5 Botol
g)
706 Larutan mengandung Karbohidrat + Elektrolit (Glukosa: 55.0 g; NaCl: 2.25 botol/softbag @ 5
g) (D5-1/4NS)
707 Larutan mengandung Karbohidrat + Elektrolit (Glukosa: 55.0 g; NaCl: 2.25 botol/softbag @ 1
g) (D5-1/4NS)
708 Larutan mengandung Karbohidrat + Elektrolit (Glukosa: 55.0 g; NaCl: 4.5 Botol
g) (D5-1/2NS)
709 Larutan mengandung karbohidrat + elektrolit (Kombinasi NaCl 18,6 g, KCl Botol
0,3 g, CaCl2 0,48 g, dextrose 50 g per 1000 ml)
710 Larutan mengandung Karbohidrat + Elektrolit (Larutan nutrisi kombinasi Botol
infus per L: Na. 100mEQ, K 18mEQ, Ca. 4mEQ, Mg 6mEQ, Cl 90mEQ,
Asetat 38mEQ, Sorbitol 50g)

711 Larutan mengandung Karbohidrat + Elektrolit (Larutan Ringer & Glukosa Botol
5%)
712 Larutan mengandung Karbohidrat + Elektrolit (NaCl 0.585 gr, KCl 0.3 gr, Botol plastik @50
Na Lactat 0.56 gr, Dekstrosa 18,75 gr) (KA EN 4B)
713 Larutan mengandung Karbohidrat + Elektrolit (NaCl 0.585 gr, Na Lactat Botol plastik @50
0.56 gr, anhydrous dekstrosa 20 gr) (KA EN 4A)
714 Larutan mengandung Karbohidrat + Elektrolit (NaCl 1.125 gr, Dekstrosa Botol
18.75 gr) (KA EN 1B)
715 Larutan mengandung Karbohidrat + Elektrolit (NaCl 1.75 g, KCL 1.5g, Botol
Glukosa 100 gr)
716 Larutan mengandung Karbohidrat + Elektrolit (NaCl 1.75 g, KCL 1.5g, Na Botol
Lactate 2.24 g, Glukosa 100 gr)
717 Larutan mengandung Karbohidrat + Elektrolit (Nacl 1.75 gr, KCl 1.5 gr, Na Botol
Lactat 2.24 gr, Dekstrosa 27 gr) (KA EN 3B)
718 Larutan mengandung Karbohidrat + Elektrolit (Nacl 2.34 gr, Na Laktat Botol
2.24 gr, KCL 0.75 gr Dekstrosa 27 gr) (KA EN 3A)
719 Larutan mengandung Lipid (Emulsi lemak 20%) Botol
720 Larutan mengandung Lipid (Highly refined fish oil, Glyserol dan purified Botol
egg phospolipid)
721 Larutan mengandung Lipid (Infus Lipid Emulsi MCT/LCT 20% 100 ml) Botol

722 Larutan mengandung Lipid (Infus Lipid Emulsi MCT/LCT 20% 250 ml) Botol

723 Larutan mengandung Lipid (Kombinasi Glukosa dan elektrolit 180 gr + Botol
Asam Amino 71.8 gr + Lipid 50 gr dgn akses sentral)
724 Larutan mengandung Lipid (Kombinasi Glukosa dan elektrolit 80 gr + Botol
Asam Amino 40 gr + Lipid MCT/LCT 50 gr)
725 Larutan mengandung Lipid (Kombinasi Glukosa dan elektrolit 90 gr + Botol
Asam Amino 35.9 gr + Lipid 25 gr dgn akses sentral)
726 Latanoprost tts mata 0,005% botol @ 2,5 mL
727 Latanoprost tts mata 0,005% catchcover, botol
728 Leflunomid tab sal selaput 20 mg tablet salut selapu
729 Lenograstim inj 263 mcg/vial Vial
730 Letrozol tab 2,5 mg tablet/kapsul/kapl
731 Leuprorelin asetat serb inj 1,88 mg Vial
732 Leuprorelin asetat serb inj 11,25 mg Vial
733 Leuprorelin asetat serb inj 22,5 mg Vial
734 Leuprorelin asetat serb inj 3,75 mg ampul/vial
735 Leuprorelin asetat serb inj 7,5 mg Vial
736 Levetirasetam tab 250 mg Tablet
737 levetirasetam tab 500 mg Tablet
738 Levofloksasin inf 5 mg/ml vial/ botol/ flexy
739 Levofloksasin inf 5 mg/ml vial / botol / flex
740 Levofloksasin tab 250 mg tablet/kapsul/kapl
741 Levofloksasin tab 500 mg tablet salut selapu
742 Levofloksasin tts mata 0,5% botol @ 5mL
743 Levonorgestrel implan 2 rods, 75 mg (3-4 tahun) pack/ sachet/ set
744 Levotiroksin tab 100 mcg tablet/kaplet/kaps
745 Levotiroksin tab 50 mcg tablet/kaplet/kaps
746 Lidokain gel 2% syringe/syringe pla
747 Lidokain inj 100 mg, vial (i.v.) Vial
748 Lidokain inj 2% (infiltr/p.v.) ampul/vial
749 Lidokain salep 5% Tube
750 Lidokain spray oral 10% botol
751 Linestrenol tab 0,5 mg tablet/kapsul/kapl
752 Linestrenol tablet 5 mg Tab
753 Liquor carbonis detergens lar 5% Botol
754 Lisinopril tab 10 mg tablet/kapsul/kapl
755 Lisinopril tab 20 mg Tab
756 Lisinopril tab 5 mg tablet/kapsul/kapl
757 Litium karbonat tab 200 mg tablet/kapsul/kapl
758 Litium karbonat tab 400 mg tablet/kapsul/kapl
759 Loperamid tab 2 mg Tab
760 Lopinavir 100 mg + Ritonavir 25 mg tab sal selaput
761 Loratadin tab 10 mg tablet/kapsul/kapl
762 Lorazepam tab 0,5 mg tablet/kapsul/kapl
763 Lorazepam tab 1 mg tablet/kapsul/kapl
764 Lorazepam tab sal 2 mg Tab sal
765 Low molecule feri sucrose inj amp 100 mg/5 ml ampul/vial
766 Lugol Botol
767 MAA (macro agregate albumin) 0,11-2,5 mg albumin Vial
aggregated/reaction vial
768 MAG3 (mercapto acetyl tri glysine) 1 mg betiatide/vial Vial
769 Magnesium sulfat inj 20% ampul/vial
770 Magnesium sulfat inj 20% ampul/vial @25 m
771 Magnesium sulfat inj 40% ampul/vial
772 Magnesium sulfat inj 40% ampul/vial @25 m
773 Magnesium sulfat serb, ktg 30 g Sachet
774 Manitol lar infus 20% Botol @ 100 ml
775 Manitol lar infus 20% Botol @ 250 ml
776 Manitol lar infus 20% Botol @ 500 ml
777 Maprotilin hcl tab sal 25 mg Tab sal
778 Maprotilin hcl tab sal 50 mg tablet salut selapu
779 MDP (methylene diphosphonate) 1 mg methylene diphosphonic acid/ml Vial

780 Mebendazol sir 100 mg/5 ml Botol

781 Mebendazol tab 100 mg Tan
782 Mebendazol tab 500 mg tablet/kapsul/kapl
783 Medroksi progesteron asetat inj 150 mg/ml ampul/vial
784 Medroksi Progesteron Asetat Inj 50 mg/ml ampul/vial
785 Medroksi progesteron asetat tab 10 mg tablet/kapsul/kapl
786 Medroksi progesteron asetat tab 100 mg tablet/kapsul/kapl
787 Medroksi progesteron asetat tab 5 mg Tab
788 Melfalan tab 2 mg tablet/kapsul/kapl
789 Merkaptopurin tab 50 mg Tab
790 Meropenem serb inj 1000 mg/vial ampul/vial
791 Meropenem serb inj 500 mg/vial ampul/vial
792 Mesalazin tab sal 250 mg tablet salut enteri
793 Mesna inj 100 mg/ml Vial
794 Metadon sir 50 mg/5 ml Botol 1000 ml
795 Metamizol Inj 500 mg/ml Ampul
796 Metenamin mandelat (heksamin mandelat) tab salut enterik 500 mg Tab salut

797 Metformin tab 500 mg tablet/kapsul/kapl

798 Metformin tab 850 mg tablet/kapsul/kapl
799 Metildopa tab sal 250 mg tablet/kapsul/kapl
800 Metilergometrin inj 0,2 mg/ml ampul/vial
801 Metilergometrin tab salut 0,125 mg tablet/kaplet salut
802 Metilfenidat tab 10 mg tablet/kapsul/kapl
803 Metilfenidat tab lepas lambat 18 mg tablet/kapsul/kap
804 Metilfenidat tab lepas lambat 36 mg tablet/kapsul/kap
805 Metilprednisolon inj 125 mg/2 ml ampul/vial
806 Metilprednisolon inj 500 mg/8 ml ampul/vial
807 Metilprednisolon tab 16 mg tablet/kapsul/kapl
808 Metilprednisolon tab 4 mg tablet/kapsul/kapl
809 Metilprednisolon tab 8 mg tablet/kapsul/kapl
810 Metoklopramid drop 2 mg/ml botol @ 10mL
811 Metoklopramid inj 5 mg/ml ampul/vial
812 Metoklopramid sir 5 mg/5 ml Botol
813 Metoklopramid tab 10 mg tablet/kapsul/kapl
814 Metoklopramid tab 5 mg tablet/kapsul/kapl
815 Metoprolol tartat inj 1 mg/ml Ampul
816 Metotreksat Inj 10 mg/ml Vial
817 Metotreksat inj 2,5 mg/ml Vial
818 Metotreksat serb inj 25 mg/ml Vial
819 Metotreksat serb inj 5 mg/vial Vial
820 Metotreksat tab 2,5 mg Tab
821 Metronidazol lar inf 5 mg/ml botol
822 Metronidazol ovula 500 mg Ovula
823 Metronidazol sup 500 mg Suppositoria
824 Metronidazol susp 125 mg/5 ml Botol @ 60 ml
825 Metronidazol susp 125 mg/5 ml Botol @ 100 ml
826 Metronidazol tab 250 mg tablet/kapsul/kapl
827 Metronidazol tab 500 mg tablet/kapsul/kapl
828 MIBG (meta-iodobenzylguanidine) Vial
829 MIBI (metoxy iso butyl isonitril) 5-ml reaction vial Vial
830 Midazolam inj 1 mg/ml (i.v.) Vial
831 Midazolam inj 5 mg/ml (i.v.) Vial
832 Mikafungin Na serb inj 50 mg/vial Vial
833 Mikofenolat mofetil tab 500 mg tablet/kapsul/kapl
834 Mikofenolat Sodium Tab Sal 180 mg tablet salut/kaplet
835 Mikofenolat Sodium Tab Sal 360 mg tablet salut/kaplet
836 Mikonazol krim 2% tube
837 Mikonazol serb 2% botol / sachet
838 Milrinone inj 1 mg/ml ampul/vial
839 Mineral Mix (Bismuth Subcitrate Tripotasium, Copper sulfate, Sachet
Magnesium Chloride Anhydrous, Potassium Chloride, Zinc Acetate)

840 Mitomisin serb inj 10 mg Vial

841 Mitomisin serb inj 2 mg Vial
842 Moksifloksasin inf 1,6 mg/mL vial/ampul/botol/
843 Moksifloksasin tab 400 mg tablet salut selapu
844 Moksifloksasin tts mata 0,5% Botol
845 Mometason furoat krim 0,1% tube 10 gram
846 Mometason furoat krim 0,1% Tube 5 gram
847 Morfin Hcl inj 10 mg/ml (i.m./s.k./i.v.) Vial
848 Morfin Hcl tab 10 mg tablet/kapsul/kapl
849 Morfin Hcl tab SR 10 mg tablet lepas lamba
850 Morfin Hcl tab SR 15 mg tablet lepas lamba
851 Morfin Hcl tab SR 30 mg Tab
852 Mupirosin krim 2% tube
853 Mupirosin salep 2% tube
854 N-asetil sistein granula 200 mg Sachet
855 N-asetil sistein ih 100 mg/ml Botol
856 N-asetil sistein kaps 200 mg tablet/kapsul/kap
857 NaCl 0,9% Larutan Botol @100 ml
858 NaCl 0,9% Larutan Ampul/botol @ 10
859 NaCl 0,9% Larutan Botol @1.000 mL
860 NaCl 0,9% Larutan Botol @500 ml
861 NaCl 0,9% Larutan Botol @25 ml
862 NaCl 0,9% Larutan Botol @250 ml
863 NaCl 3% Larutan Botol plastik @50
864 Nadroparin inj 9.500 Axa/ml syringe 0,3 Ml Vial
865 Nadroparin inj 9.500 Axa/ml, syringe 0,4 ml Vial
866 Nadroparin inj 9.500 Axa/ml, syringe 0,6 ml Vial
867 Nalokson inj 0,4 mg/ml Ampul
868 Natamisin tts mata 5% (50 mg/ml) Botol @5 ml
869 Natamisin tts mata 5% (50 mg/ml) botol @ 15 mL
870 Natamisin tts mata 5% (50 mg/ml) catchcover, botol
871 Natrium aminohipurat inj 200 mg/ml (i.v.) Ampul
872 Natrium bikarbonat inj 8,4% (i.v.) Vial
873 Natrium bikarbonat tab 500 mg tablet/kapsul/kapl
874 Natrium diklofenak inj 25 mg/mL ampul/vial
875 Natrium diklofenak tab 25 mg tablet salut enter
876 Natrium diklofenak tab 50 mg tablet salut enter
877 Natrium Diklofenak Tetes Mata 1 mg/ml botol 5 mL
878 Natrium fluoresein tts mata 2% Botol
879 Natrium fosfat lar oral botol
880 Natrium fusidat krim 20 mg/g tube
881 Natrium fusidat salep 20 mg/g Tube
882 Natrium hialuronat tts mata botol
883 Natrium hipoklorit cairan konsentrat 5% Botol
884 Natrium klorida tts mata 50 mg/mL ampul/vial
885 Natrium tiosulfat inj 25% (i.v.) Ampul
886 Neostigmin inj 0,5 mg/ml Vial
887 Nevirapin tab 200 mg tablet/kapsul/kapl
888 Nifedipin kaps 10 mg tablet/kapsul/kapl
889 Nifedipin tab SR 20 mg tablet lepas lamb
890 Nifedipin tab SR 30 mg tablet lepas lamb
891 Nikardipin inj 10 mg/vial ampul/vial
892 Nilotinib kaps 150 mg tablet/kapsul/kapl
893 Nilotinib tab 200 mg tablet/kapsul/kapl
894 Nimodipin inf 0,2 mg/ml ampul/vial/botol
895 Nimodipin tab 30 mg tablet salut selapu
896 Nistatin susp 100.000 UI/ml botol/vial
897 Nistatin tab salut 500.000 UI tablet salut gula/k
898 Nistatin tab vaginal 100.000 UI tablet/kaplet
899 Nitrofurantoin tab 50 mg Tab
900 Nitrogen oksida ih, gas dlm tabung Botol
901 Nomegestrol asetat Kaps/tab 5 mg tablet/kapsul/kapl
902 Norepinefrin inj 1 mg/ml ampul/vial
903 Noretisteron tab 5 mg tablet/kapsul/kapl
904 Obat Anti Tuberculosis FDC Kategori Anak paket
905 Obat Anti Tuberculosis FDC Kategori I paket
906 Obat Anti Tuberculosis FDC Kategori II paket
907 Obat Anti Tuberculosis FDC Kategori Sisipan paket
908 Obat Anti Tuberculosis Kombipak Anak Paket
909 Obat Anti Tuberculosis Kombipak Dewasa paket
910 Ofloksasin tab 200 mg tablet salut selapu
911 Ofloksasin tab 400 mg tablet salut selapu
912 Ofloksasin tts telinga 3% Botol @ 5 mL
913 Oksaliplatin serb inj 100 mg/vial Vial
914 Oksaliplatin serb inj 50 mg/vial Vial
915 Oksigen ih, gas dlm tabung Botol
916 Oksikodon inj 10 mg/ml Ampul/vial @1 mL
917 Oksikodon inj 10 mg/ml Ampul/vial @2 mL
918 Oksikodon kapsul 10 mg Kaps
919 Oksikodon kapsul 20 mg Kaps
920 Oksikodon kapsul 5 mg tablet/kapsul/kapl
921 Oksikodon tab lepas lambat 10 mg Tab
922 Oksikodon tab lepas lambat 15 mg Tab
923 Oksikodon tab lepas lambat 20 mg Tab
924 Oksimetazolin tts hidung 0,025% botol @ 10 mL
925 Oksimetazolin tts hidung 0,050% botol @ 10 mL
926 Oksitetrasiklin 1% Salep Mata tube
927 Oksitetrasiklin hcl inj 50 mg/ml (i.m.) Vial
928 Oksitosin inj 10 UI/ml ampul/vial
929 Okskarbazepin susp 60 mg/mL botol
930 Oktreotid asetat 0,05 - 6 mg/ml ampul/vial
931 Oktreotid LAR serb inj 20 mg Vial
932 Oktreotid LAR serb inj 30 mg vial
933 Olanzapin inj 10 mg/2 ml Ampul
934 Olanzapin tab sal 10 mg tablet salut selapu
935 Olanzapin tab sal 5 mg tablet salut selapu
936 Olodaterol cairan ih 2,5 mcg/semprot Botol
937 Olopatadin tts mata 0,1% Botol
938 Omeprazol inj 40 mg/10 ml ampul/vial
939 Omeprazol kaps 20 mg tablet/kapsul/kapl
940 Ondansetron inj 2 mg/ml ampul/vial
941 Ondansetron tab 4 mg tablet/kapsul/kapl
942 Ondansetron tab 8 mg tablet/kapsul/kapl
943 Paklitaksel inj 6 mg/ml, vial@16,7 ml (inj 100 mg) Vial
944 Paklitaksel inj 6 mg/ml, vial@5 ml (inj 30 mg) Vial
945 Paklitaksel inj 6 mg/ml, vial@50 ml (inj 300 mg) Vial
946 Paliperidon palmitat Inj 100 mg/mL Ampul
947 Paliperidon palmitat Inj 150 mg/1,5 mL Ampul
948 Paliperidon palmitat Inj 50 mg/0,5 mL Ampul
949 Paliperidon palmitat Inj 75 mg/0,75 mL Ampul
950 Pankuronium inj 2 mg/ml Ampul
951 Paraformaldehid lar buffer 10% Botol
952 Paraformaldehid tab 1 g Tab
953 Parasetamol drips (infus) 1000 mg/100 ml vial/ flexybag/bo
954 Parasetamol sir 120 mg/5 ml botol @ 60 mL
955 Parasetamol tab 500 mg tablet/kapsul/kapl
956 Parasetamol tts 60 mg/0,6 ml botol @ 15 mL
957 Pasta devitalisasi (non arsen) Tube
958 Pasta pengisi saluran akar (pasta) Tube
959 Pegylated interferon alfa-2a inj 135 mcg/0,5 ml Vial
960 Pegylated interferon alfa-2a inj 180 mcg/0,5 ml Vial
961 Pegylated interferon alfa-2b serb inj 100 mcg/ml Vial
962 Pegylated interferon alfa-2b serb inj 50 mcg/ml Vial
963 Pegylated interferon alfa-2b serb inj 80 mcg/ml Vial
964 Pemetreksed serb inj 500 mg Vial
965 Pengganti plasma golongan gelatin inf Botol
966 Perak nitrat lar 20% Botol
967 Perak sulfadiazin krim 1% Tube
968 Perindoprilarginin tab 5 mg tablet/kapsul/kapl
969 Permetrin krim 5 % Tube 30 g
970 Permetrin krim 5 % Tube 10 g
971 Permetrin krim 5 % Tube 15 g
972 Petidin inj 50 mg/ml (i.m./s.k./i.v.) Vial
973 Pilokarpin tts mata 2% Botol 5 ml
974 Pilokarpin tts mata 2% Catchcover, botol
975 Pioglitazon tab 15 mg tablet
976 Pioglitazon tab 30 mg tablet/kapsul/kapl
977 Pirantel pamoat susp 125 mg/5 ml Botol
978 Pirantel pamoat tab 500 mg Tab
979 Pirantel pamoat tab scored 125 mg tablet/kapsul/kapl
980 Pirantel pamoat tab scored 250 mg Tab
981 Piridoksin (vitamin B6) inj 100 mg/ml Ampul
982 Piridoksin (vitamin B6) tab 10 mg tab/kap/kapl
983 Piridoksin (vitamin B6) tab 25 mg tablet/kapsul/kapl
984 Piridostigmin tab sal 60 mg tablet/kapsul/kapl
985 Pirimetamin tab 25 mg Tablet
986 Podofilin tingtur 25 % Botol
987 Polietilen glikol Botol
988 Polikresulen Botol
989 Povidon iodin lar 100 mg/ml botol @ 1.000 mL
990 Povidon iodin lar 100 mg/ml botol 30 mL
991 Povidon iodin lar 100 mg/ml botol @ 60 mL
992 Povidon iodin lar 100 mg/ml Botol 300 ml
993 Pramipeksol tab 0,125 mg tablet/kapsul/kapl
994 Pramipeksol tab ER 0,375 mg tablet lepas lamba
995 Pramipeksol tab ER 0,750 mg tablet lepas lamba
996 Pravastatin tab 10 mg Tab
997 Pravastatin tab 20 mg tablet/kapsul/kapl
 998 Prazikuantel tab scored 600 mg Tab
999 Prednisolon tts mata 10 mg/ml catchcover, botol
1000 Prednisolon tts mata 10 mg/ml Botol @5mL
1001 Prednison tab 5 mg tablet/kapsul/kapl
1002 Primakuin tab 15 mg Tab
1003 Probenesid tab 500 mg tablet/kapsul/kapl
1004 Produk untuk Dialisis Peritoneal Paket
1005 Prokain benzilpenisilin serb inj 3 juta UI/vial (i.m.) ampul/vial
1006 Prokaterol HCl cairan ih 30 mcg Vial
1007 Prokaterol HCl cairan ih 50 mcg Botol
1008 Prokaterol HCl serb ih 10 mcg Botol
1009 Propiltiourasil tab 100 mg tablet/kapsul/kapl
1010 Propofol inj 1% (i.v. Bolus) ampul/vial
1011 Propranolol inj 1 mg/ml (i.v.) Ampul
1012 Propranolol tab 10 mg tablet/kapsul/kapl
1013 Propranolol tab 40 mg tablet/kapsul/kapl
1014 Prostaglandin (PGE 1) Inj 500 mcg/ml Vial
1015 Protamin sulfat inj 10 mg/ml (i.m.) Ampul
1016 Quetiapin tab 100 mg tablet/kapsul/kapl
1017 Quetiapin tab SR 200 mg tablet SR/kaplet S
1018 Quetiapin tab SR 300 mg tab SR
1019 Quetiapin tab SR 400 mg tablet SR/kaplet S
1020 Ramipril tab 10 mg tablet/kapsul/kapl
1021 Ramipril tab 2,5 mg tablet/kapsul/kapl
1022 Ramipril tab 5 mg tablet/kapsul/kapl
1023 Ranibizumab inj 10 mg/ml Vial
1024 Ranitidin inj 25 mg/ml ampul/vial
1025 Ranitidin tab 150 mg tablet/kapsul/kapl
1026 Retinol (vitamin A) kaps lunak 100.000 UI kaps lunak
1027 Retinol (vitamin A) kaps lunak 200.000 UI kaps lunak
1028 Ribavirin tab 200 mg tab sal selaput
1029 Rifampisin kaps 300 mg tablet/kapsul/kapl
1030 Rifampisin tab 450 mg tablet/kapsul/kapl
1031 Rifampisin tab 600 mg tablet/kapsul/kapl
1032 Rifapentin tablet 150 mg Tablet/kapsul/kapl
1033 Rilpivirine 25 mg tablet
1034 Ringer Laktat Larutan Botol
1035 Ringer Laktat Larutan 1000 ml Botol
1036 Risedronat tab sal selaput 35 mg tablet salut selapu
1037 Risperidon oral solution 1 mg/mL botol
1038 Risperidon tab 3 mg tablet/kapsul/kapl
1039 Risperidon tab sal 1 mg tablet/kapsul/kapl
1040 Risperidon tab sal 2 mg tablet/kapsul/kapl
1041 Rituksimab inf 10 mg/ml (vial 10 ml) Vial
1042 Rituksimab Inf 10 mg/ml (vial 50 ml) Vial
1043 Rituksimab inj 100 mg/ml Ampul
1044 Rituksimab inj 500 mg/ml Ampul
1045 Rivaroksaban tab sal 10 mg tablet salut/kaple
1046 Rivaroksaban tab sal 15 mg tablet salut/kaple
1047 Rivaroksaban tab sal 20 mg tablet salut/kaple
1048 Rokuronium inj 50 mg/5 ml (i.v.) ampul/vial
1049 Ropinirol tab lepas lambat 2 mg tablet lepas lamba
1050 Ropinirol tab lepas lambat 4 mg tablet lepas lamba
1051 Ropinirol tab lepas lambat 8 mg tablet lepas lamba
1052 Ropivakain Inj 7,5 mg/ml ampul/polyamp/vi
1053 Rosuvastatin tab 10 mg tablet/kapsul/kapl
1054 Salbutamol aerosol 100 mcg canister / botol
1055 Salbutamol cairan ih 1 mg/mL ampul/vial/botol
1056 Salbutamol cairan serb ih 200 mcg/kaps + rotahaler Botol
1057 Salbutamol sir 2 mg/5 ml Botol
1058 Salbutamol tab 2 mg tablet/kapsul/kapl
1059 Salbutamol tab 4 mg tablet/kapsul/kapl
1060 Salep 2-4, kombinasi : asam salisilat 2 %+ belerang endap 4 % pot 30 gram
1061 Salep 2-4, kombinasi : asam salisilat 2 %+ belerang endap 4 % pot 15 gram
1062 Secukinumab serb inj 150 mg Vial
1063 Sefadroksil kaps 250 mg tablet/kapsul/kapl
1064 Sefadroksil kaps/tab 500 mg tablet/kapsul/kapl
1065 Sefadroksil sir kering 125 mg/5 ml botol @ 60 mL
1066 Sefadroksil sir kering 250 mg/5 ml botol @ 60 mL
1067 Sefaleksin kaps 500 mg tablet/kapsul/kapl
1068 Sefazolin serb inj 1 g/vial ampul/vial
1069 Sefepim serb inj 1000 mg/vial ampul/vial
1070 Sefiksim sir 100 mg/5 ml botol
1071 Sefiksim tab 100 mg Tab
1072 Sefiksim Tab 200 mg Tablet
1073 Sefoperazon serb inj 1.000 mg/vial ampul/vial
1074 Sefotaksim inj 500 mg/vial ampul/vial
1075 Sefotaksim serb inj 1.000 mg/vial ampul/vial
1076 Sefpirom serb inj 1000 mg ampul/vial
1077 Sefpodoksim proksetil tab sal 100 mg Tab
1078 Seftazidim serb inj 1.000 mg/vial ampul/vial
1079 Seftriakson serb inj 1.000 mg/vial ampul/vial
1080 Sefuroksim serb inj 750 mg/vial ampul/vial
1081 Sefuroksim tab 250 mg tablet salut selapu
1082 Sefuroksim tab sal 500 mg tablet salut selapu
1083 Sertralin tab sal 50 mg tablet salut/kaplet
1084 Serum anti bisa ular : A.B.U. I (khusus ular dari luar Papua) inj (i.m./i.v.) Vial

1085 Serum anti bisa ular :A.B.U.II (khusus ular dari Papua) inj (i.m./i.v.) Vial
1086 Serum antidifteri (A.D.S) inj (i.m./i.v.) Inj i.m 10.000 UI/ Vial
1087 Serum antirabies inj 100 UI/ml Vial
1088 Serum antirabies inj 200 UI/ml Vial
1089 Serum antitetanus (A.T.S) (i.m.) Inj 10.000 UI/vial (i.m /i.v.) Vial
1090 Serum antitetanus (A.T.S) inj 1500 UI/amp (i.m.) Ampul
1091 Serum antitetanus (A.T.S) inj 20.000 UI/vial (i.m /i.v.) Vial
1092 Serum antitetanus (A.T.S) inj 5.000 IU/mL (i.m) Ampul/vial
1093 Setirizin sir 5 mg/5 ml. botol @ 60 mL
1094 Setirizin tab 10 mg tablet/kapsul/kapl
1095 Setuksimab inj 5 mg/ml Vial
1096 Sevelamer karbonat Tab 800 mg Tab
1097 Sevofluran cairan ih 250 ml botol
1098 Sianokobalamin (vitamin B12) inj 500 mcg/ml ampul/vial
1099 Sianokobalamin (vitamin B12) tab 50 mcg tablet/kapsul/kapl
1100 Siklofosfamid serb inj 1000 mg/vial (i.v.) Vial
1101 Siklofosfamid serb inj 200 mg/vial (i.v.) Vial
1102 Siklofosfamid serb inj 500 mg/vial (i.v.) Vial
1103 Siklopentolat tetes mata 1% Botol
1104 Siklosporin inj 100 mg/ml Ampul
1105 Siklosporin inj 50 mg/ml Ampul
1106 Siklosporin kaps 100 mg kaps lunak
1107 Siklosporin kaps lunak 25 mg kaps lunak
1108 Siklosporin Kaps lunak 50 mg Kaps lunak
1109 Sildenafil Tab 20 mg Tab
1110 Silodosin tab 4 mg Tab
1111 Silostazol kaps SR 100 mg tablet/kapsul/kapl
1112 Silostazol tab 100 mg Tab
1113 Simvastatin tab sal 10 mg tablet/kapsul/kapl
1114 Simvastatin tab sal 20 mg tablet/kapsul/kapl
1115 Simvastatin tab sal selaput 40 mg Tab sal
1116 Siprofloksasin inf 2 mg/ml vial/ botol 100 ml
1117 Siprofloksasin tab scored 500 mg tablet salut selapu
1118 Sisplatin serb inj 10 mg Vial
1119 Sisplatin serb inj 50 mg Vial
1120 Sitarabin inj 50 mg Vial
1121 Sitarabin serb inj 100 mg ampul/vial @ 1 mL
1122 Sitarabin serb inj 100 mg ampul/vial @ 10
1123 Sodium Glycerophosphate 216 mg Ampul/vial
1124 Sofosbuvir tab sal selaput 400 mg tablet salut selapu
1125 Solifenasin tab 10 mg tablet/kapsul/kapl
1126 Solifenasin tab 5 mg tablet/kapsul/kapl
1127 Somatostatin serb Inj 3000 mcg/mL Vial
1128 Soybean oil 200 g, ovolecithin 12 g, glycerol 22 g, Na hydroxide Softbag @ 250 ml
1129 Spiramisin tab 500 mg tablet salut selapu
1130 Spironolakton tab 100 mg tablet/kapsul/kapl
1131 Spironolakton tab 25 mg tablet/kapsul/kapl
1132 Stannous pyrophosphate 27,6 mg sodium pyrophosphate/vial Vial
1133 Stavudin tab 30 mg Tab
1134 Streptokinase serb inj 1,5 juta UI/vial Vial
1135 Streptomisin serb inj 1.000 mg/vial ampul/vial
1136 Sufentanil inj 5 mcg/ml (i.v.) Ampul
1137 Sugammadeks inj 100 mg/ml Vial
1138 Sukralfat susp 500 mg/5 ml botol
1139 Sukralfat tab 500 mg tablet/kapsul/kapl
1140 Suksinilkolin inj 20 mg/ml (i.v./i.m.) Vial
1141 Suksinilkolin inj 50 mg/ml (i.v./i.m.) Vial
1142 Suksinilkolin serb inj 100 mg/vial (i.v./i.m.) Vial
1143 Sulfadiazin tab 500 mg tablet/kapsul/kapl
1144 Sulfasalazin kapl sal enterik 500 mg tablet salut enter
1145 Sulfur colloid 4,5 mg gelatin/reaction vial Vial
1146 Surfaktan susp 25 mg/ml (intratrakeal) Botol
1147 Surgical ginggival pack Tube
1148 Takrolimus kaps 0,5 mg tablet/kapsul/kapl
1149 Takrolimus kaps 1 mg tablet/kapsul/kapl
1150 Takrolimus kaps lepas lambat 0,5 mg kapsul lepas lamba
1151 Takrolimus kaps lepas lambat 1 mg kapsul lepas lamba
1152 Tamoksifen tab 10 mg Tablet
1153 Tamoksifen tab 20 mg Tab
1154 Tamsulosin tab 0,2 mg tablet/kapsul/kapl
1155 Tamsulosin tab SR 0,4 mg tab lepas lambat /
1156 Technetium 99m 740 mbq - 3,7 gbq (20 to 100 millicuries)/ml Set
1157 Telbivudin tab 600 mg tablet/kapsul/kapl
1158 Telmisartan tab 40 mg tablet/kapsul/kapl
1159 Telmisartan tab 80 mg tablet/kapsul/kapl
1160 Temozolamid kaps 100 mg tablet/kapsul/kapl
1161 Temozolamid kaps 20 mg tablet/kapsul/kapl
1162 Tenofovir tab 300 mg tablet salut selapu
1163 Teofilin tab 150 mg tablet/kapsul/kapl
1164 Teofilin tab SR 300 mg tablet lepas lamb
1165 Terazosin hcl tab 1 mg tablet/kapsul/kapl
1166 Terazosin hcl tab 2 mg tablet/kapsul/kapl
1167 Terbinafin tab 250 mg tablet/kapsul/kapl
1168 Terbutalin cairan ih 2,5 mg/ml Botol
1169 Terbutalin inj 0,5 mg/ml ampul/vial
1170 Terbutalin serb ih 0,50 mg/dose Vial
1171 Terbutalin sir 1,5 mg/5 ml botol
1172 Terbutalin tab 2,5 mg tablet/kapsul/kapl
1173 Testosteron inj 250 mg/ml (vial 1 ml) Vial
1174 Testosteron Inj 250 mg/ml (vial 4 ml) Vial
1175 Testosteron kaps lunak 40 mg kapsul lunak
1176 Tetanus toxoid inj Ampul
1177 Tetrakain tts mata 0,5% Botol
1178 Tetrasiklin kaps 250 mg tablet/kapsul/kapl
1179 Tetrasiklin kaps 500 mg tablet/kapsul/kapl
1180 Tetrasiklin Salep Mata 1% Tube
1181 Thallous Chloride Tl-202 1 mg methylene diphosphonic acid/ml Set
1182 Tiamazol tab 10 mg tablet salut selap
1183 Tiamazol tab 5 mg tablet salut selap
1184 Tiamin (vitamin B1) tab 50 mg tablet/kapsul/kapl
1185 Tikagrelor tab 90 mg tablet/kapsul/kapl
1186 Timolol tts mata 0,25% botol @ 5 mL
1187 Timolol tts mata 0,5% botol @ 5 mL
1188 Tiopental serb inj 500 mg/amp (i.v. Bolus) Ampul
1189 Tiopental serb serb inj 1.000 mg/amp (i.v.) Ampul
1190 Tiotropium respimat ih 5 mcg/semprot Handihaler
1191 Tiotropium respimat ih 5 mcg/semprot Botol
1192 Tobramisin tetes mata 0,3% Botol @ 5 ml
1193 Tobramisin tetes mata 0,3% Catchcover, botol
1194 Topiramat tab 100 mg tablet/kapsul/kapl
1195 Topiramat tab 25 mg tablet/kapsul/kapl
1196 Topiramat tab 50 mg tablet/kapsul/kapl
1197 Tosilizumab inf 400 mg/20 mL vial
1198 Tosilizumab inf 80 mg/4 mL vial
1199 Trastuzumab serb inj 440 mg/vial ampul/vial
1200 Travoprost tts mata 0,004% Botol
1201 Triamsinolon asetonid nasal spray 55 mcg/puff Botol
1202 Triamsinolon inj 10 mg/ml Ampul
1203 Triamsinolon inj 40 mg/ml ampul/vial
1204 Trifluoperazin tab sal 5 mg tablet salut selap
1205 Triheksifenidil tab 2 mg tablet/kapsul/kapl
1206 Tropikamid tts mata 0,5% Catchcover, botol
1207 Tropikamid tts mata 0,5% Botol @ 5 ml
1208 Tuberkulin protein purified derivative 1:10 (i.k) Ampul
1209 Urea krim 10 % Tube/pot
1210 Urea krim 20 % Tube/pot
1211 Vaksin BCG inj (i.k) Vial
1212 Vaksin bivalen OPV (b-OPV) drops 10 dosis Vial
1213 Vaksin Hepatitis Rekombinan Inj Prefilled Injection Device (Uniject) 0,5 Vial
ml (i.m)
1214 Vaksin HPV (Human Papilloma Virus), vial 0,5 mL Ampul/vial
1215 Vaksin Influenza Vial
1216 Vaksin Japanese Enchepalitis (J.E) Vial
1217 Vaksin jerap difteri tetanus (DT) Vial
1218 Vaksin jerap difteri tetanus (Td) Vial
1219 Vaksin kombinasi DPT-HB-Hib Vial
1220 Vaksin measless rubella (MR) Inj 0,5 mL (s.k) Vial
1221 Vaksin Meningitis Meningokokus Vial
1222 Vaksin polio IPV inj 0,5 ml Vial
1223 Vaksin rabies, untuk manusia serb inj (s.k./i.k) + booster Vial
1224 Vaksin rabies, untuk manusia serb Inj 2,5 IU Vial
1225 Vaksin Yellow Fever Vial
1226 Valasiklovir tab 500 mg tablet/kapsul/kapl
1227 Valgansiklovir tab sal 450 mg tablet salut/kaplet
1228 Valproat sir 250 mg/5 ml botol @ 120 ml
1229 Valproat tab sal 250 mg tablet salut enteri
1230 Valproat tab SR 250 mg tabet lepas lambat
1231 Valproat tab SR 500 mg tabet lepas lambat
1232 Valsartan tab 160 mg tablet/kapsul/kapl
1233 Valsartan tab 80 mg tablet salut/kaplet
1234 Vankomisin serb inj 500 mg/vial Vial
1235 Vasopresin inj 20 UI/ml (i.m./s.k.) Vial
1236 Verapamil inj 2,5 mg/ml Vial
1237 Verapamil tab 240 mg tablet lepas lamba
1238 Verapamil tab 80 mg tablet/kapsul/kapl
1239 Vildagliptin tab 50 mg Tab
1240 Vinblastin inj 1 mg/ml Ampul
1241 Vinkristin inj 1 mg/ml (vial 1 mL) Vial
1242 Vinkristin inj 1 mg/ml (vial 2 mL) Vial
1243 Vinorelbin inj 10 mg/ml, kemasan 1 ml Vial
1244 Vinorelbin inj 10 mg/ml, kemasan 5 ml Vial
1245 Vitamin B kompleks tablet
1246 Vitamin C 500 mg minimal non acidic 250 mg Tablet/kapsul/kaple
1247 Vorikonazol inj 200 mg vial
1248 Vorikonazol tab sal selaput 200 mg tablet/kapsul/kapl
1249 Warfarin tab 1 mg tablet/kapsul/kapl
1250 Warfarin tab 2 mg tablet/kapsul/kapl
1251 Zidovudin kaps 100 mg tablet/kapsul/kapl
1252 Zinc drops 10 mg/ml Botol
1253 Zinc serb 10 mg Sachet
1254 Zinc sir 20 mg/5 ml botol
1255 Zinc tab disp 20 mg tablet dispersible
 TUAN KERJA
N UNTUK DIADAKAN TAHUN 2021
PER BULAN DI SATKER SELAMA TAHUN 2020
DITAMBAH PREDIKSI PENGADAAN TAHUN 2021 DIKURANGI (12 x PEMAKAIAN RATA-RATA PER BULAN TAHUN 2020)
AMA 2020 DIKALI 15 BULAN DALAM SATUAN TERKECIL SEPERTI : TABLET / KAPSUL / KAPLET / BOTOL / AMPUL / VIAL / TUBE / SACCHET /
BERDASARKAN METODE KONSUMSI DIKURANGI DENGAN PREDIKSI SISA STOK PER 31 DESEMBER 2021
UN 2022 DALAM SATUAN TERKECIL SEPERTI: TABLET / KAPSUL / KAPLET / BOTOL / AMPUL / VIAL / TUBE / SACCHET / PUFF YANG AKAN D
ATKER TELAH MENGIRIMKAN PELAPORAN RKO TAHUN 2021
IK E-PURCHASING MAUPUN MANUAL SELAMA TAHUN 2022

RUJUKAN TINGKAT LANJUT (FKRTL) TAHUN 2022

SISA STOK PER PREDIKSI PEMAKAIAN PREDIKSI SISA STOK 31 JUMLAH

31 DESEMBER PENGADAAN RATA-RATA PER DESEMBER 2021 KEBUTUHAN
2020 TAHUN 2021 BULAN SELAMA TAHUN 2022
2020

(a) (b) (c) (d) = (a)+(b)-(12x(c)) (e) = (c) x 15

0 0 0 0 0

0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
137 1000 109 0 1635
0 400 69 0 1035
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
304 300 78 0 1170
917 1000 158 21 2370
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
 0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
75 200 71 0 1065
159 100 13 103 195
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
6 50 6 0 90
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
164 3000 149 1376 2235
830 3000 290 350 4350
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
154 1500 119 226 1785
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0

14 45 4 11 60
0 0 0 0 0

0 0 0 0 0

28 250 21 26 315

0 0 0 0 0
28 185 14 45 210
 0 0 0 0 0
0 0 0 0 0

167 300 22 203 330

2 20 3 0 45

0 0 0 0 0
0 0 0 0 0

0 0 0 0 0
0 0 0 0 0

0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
179 13 13 36 195
419 3200 332 0 4980
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
1106 100 95 66 1425
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
548 3500 310 328 4650
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
31 70 6 29 90
0 0 0 0 0
326 0 15 146 225
 98 100 12 54 180
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
120 0 20 0 300
162 100 20 22 300
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
148 1500 116 256 1740
0 0 0 0 0
0 0 0 0 0
75 300 17 171 255
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
2 25 3 0 45
0 0 0 0 0
76 290 22 102 330
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
140 1500 126 128 1890
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
 0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
433 2000 186 201 2790
226 500 32 342 480
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0

0 0 0 0 0

0 0 0 0 0

0 0 0 0 0
0 0 0 0 0
31 300 26 19 390
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
 0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
215 0 0 215 0
105 0 0 105 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
4 0 0 4 0
12 0 0 12 0
4 0 0 4 0
49 0 0 49 0
4 0 0 4 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
248 0 0 248 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0

0 0 0 0 0
0 0 0 0 0
4 0 0 4 0
 0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
10 0 0 10 0
433 0 0 433 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0

0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
49 0 0 49 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
25 0 0 25 0
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0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
 0 0 0 0 0
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0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0

0 0 0 0 0

0 0 0 0 0

0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
48 0 0 48 0
0 0 0 0 0
0 0 0 0 0
4 0 0 4 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
140 0 0 140 0
22 0 0 22 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
 0 0 0 0 0
65 0 0 65 0
37 0 0 37 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
42 0 0 42 0
0 0 0 0 0
0 0 0 0 0
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0 0 0 0 0
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0 0 0 0 0
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0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
12 0 0 12 0
1036 0 0 1036 0
234 0 0 234 0
255 0 0 255 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
 0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
130 0 0 130 0

0 0 0 0 0
302 0 0 302 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0

0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
84 0 0 84 0
361 0 0 361 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
510 0 0 510 0
503 0 0 503 0
494 0 0 494 0
421 0 0 421 0
496 0 0 496 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
63 0 0 63 0
53 0 0 53 0
58 0 0 58 0
 0 0 0 0 0
162 0 0 162 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
987 0 0 987 0
6 0 0 6 0
4 0 0 4 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0

0 0 0 0 0

0 0 0 0 0

0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
 0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
5 0 0 5 0
0 0 0 0 0
340 0 0 340 0
143 0 0 143 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0

0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
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0 0 0 0 0
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0 0 0 0 0
0 0 0 0 0
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0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
 0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
202 0 0 202 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
4 0 0 4 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
13 0 0 13 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
261 0 0 261 0
0 0 0 0 0
0 0 0 0 0
372 0 0 372 0
221 0 0 221 0
0 0 0 0 0
0 0 0 0 0
305 0 0 305 0
302 0 0 302 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
 0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
83 0 0 83 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
26 0 0 26 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
29 0 0 29 0
187 0 0 187 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
 0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
138 0 0 138 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0

0 0 0 0 0

0 0 0 0 0

0 0 0 0 0

0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0

0 0 0 0 0

0 0 0 0 0

0 0 0 0 0
0 0 0 0 0

0 0 0 0 0

0 0 0 0 0
0 0 0 0 0
0 0 0 0 0

0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0

0 0 0 0 0

0 0 0 0 0

0 0 0 0 0

0 0 0 0 0

0 0 0 0 0

0 0 0 0 0

0 0 0 0 0

0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0

0 0 0 0 0

0 0 0 0 0

0 0 0 0 0

0 0 0 0 0

0 0 0 0 0

0 0 0 0 0
0 0 0 0 0

0 0 0 0 0

0 0 0 0 0

0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
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AN TAHUN 2020)
OL / AMPUL / VIAL / TUBE / SACCHET / PUFF

TUBE / SACCHET / PUFF YANG AKAN DIADAKAN TAHUN 2021 BERDASARKAN

RENCANA RENCANA RENCANA REALISASI KETERANGAN

KEBUTUHAN PENGADAAN PENGADAAN PENGADAAN
TAHUN 2022 TAHUN 2022 TAHUN 2021 TAHUN 2020

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